Skip to Content

Antibiotics Guide

Medically reviewed by L. Anderson, PharmD Last updated on Jun 11, 2019.

When To Use|When NOT To Use|Top 10 Infections Treated|Top 10 Generic Drugs|Top 10 Brand Drugs|Antibiotic Class Types|OTC Options |More Resources

Taking Antibiotics

You’ve most likely taken an antibiotic or anti-infective at least once in your lifetime. From treatments for painful strep throat or ear infections as a child, to burning urinary tract infections or itchy skin infections as an adult, antibiotics are one of the most highly utilized and important medication classes we have in medicine.

Understanding the vast world of antibiotics and anti-infectives is no easy task. Anti-infectives are a large class of drugs that cover a broad range of infections, including fungal, viral, bacterial, and even protozoal infections.

  • Athletes foot? That’s a common fungal infection.
  • HIV? Antiviral medications are always needed.
  • Bladder infection? Yes, that may need a common oral antibiotic.
  • Head lice? A topical anti-parasitic can alleviate the itching.

There is no one type of antibiotic that cures every infection. Antibiotics specifically treat infections caused by bacteria, such as Staph., Strep., or E. coli., and either kill the bacteria (bactericidal) or keep it from reproducing and growing (bacteriostatic). Antibiotics do not work against any viral infection.

When To Use Antibiotics

Antibiotics are specific for the type of bacteria being treated and, in general, cannot be interchanged from one infection to another. When antibiotics are used correctly, they are usually safe with few side effects.

However, as with most drugs, antibiotics can lead to side effects that may range from being a nuisance to serious or life-threatening. In infants and the elderly, in patients with kidney or liver disease, in pregnant or breastfeeding women, and in many other patient groups antibiotic doses may need to be adjusted based upon the specific characteristics of the patient, like kidney or liver function, weight, or age. Drug interactions can also be common with antibiotics. Health care providers are able to assess each patient individually to determine the correct antibiotic and dose.

When NOT To Use Antibiotics

Antibiotics are not the correct choice for all infections. For example, most sore throats, cough and colds, flu or acute sinusitis are viral in origin (not bacterial) and do not need an antibiotic. These viral infections are “self-limiting”, meaning that your own immune system will usually kick in and fight the virus off. In fact, using antibiotics for viral infections can increase the risk for antibiotic resistance, lower the options for future treatments if an antibiotic is needed, and put a patient at risk for side effects and extra cost due to unnecessary drug treatment.

Antibiotic resistant bacteria cannot be fully inhibited or killed by an antibiotic, even though the antibiotic may have worked effectively before the resistance occurred. Don't share your antibiotic or take medicine that was prescribed for someone else, and don't save an antibiotic to use the next time you get sick.

To better understand antibiotics, it’s best to break them down into common infections, common antibiotics, and the top antibiotic classes as listed in Drugs.com.

Top 10 List of Common Infections Treated with Antibiotics

  1. Acne
  2. Bronchitis
  3. Conjunctivitis (Pink Eye)
  4. Otitis Media (Ear Infection)
  5. Sexually Transmitted Diseases (STD’s)
  6. Skin or Soft Tissue Infection
  7. Streptococcal Pharyngitis (Strep Throat)
  8. Traveler’s diarrhea
  9. Upper Respiratory Tract Infection
  10. Urinary Tract Infection (UTI)

Top 10 List of Generic Antibiotics

  1. amoxicillin
  2. doxycycline
  3. cephalexin
  4. ciprofloxacin
  5. clindamycin
  6. metronidazole
  7. azithromycin
  8. sulfamethoxazole and trimethoprim
  9. amoxicillin and clavulanate
  10. levofloxacin

Top 10 List of Brand Name Antibiotics

  1. Augmentin
  2. Flagyl, Flagyl ER
  3. Amoxil
  4. Cipro
  5. Keflex
  6. Bactrim, Bactrim DS
  7. Levaquin
  8. Zithromax
  9. Avelox
  10. Cleocin

Top 10 List of Antibiotic Classes (Types of Antibiotics)

  1. Penicillins
  2. Tetracyclines
  3. Cephalosporins
  4. Quinolones
  5. Lincomycins
  6. Macrolides
  7. Sulfonamides
  8. Glycopeptides
  9. Aminoglycosides
  10. Carbapenems

Most antibiotics fall into their individual antibiotic classes. An antibiotic class is a grouping of different drugs that have similar chemical and pharmacologic properties. Their chemical structures may look comparable, and drugs within the same class may kill the same or related bacteria.

However, it is important not to use an antibiotic for an infection unless your doctor specifically prescribes it, even if it's in the same class as another drug you were previously prescribed. Antibiotics are specific for the kind of bacteria they kill. Plus, you would need a full treatment regimen to effectively cure your infection, so don't use or give away leftover antibiotics.

1. Penicillins

Another name for this class is the beta-lactam antibiotics, referring to their structural formula. The penicillin class contains five groups of antibiotics: aminopenicillins, antipseudomonal penicillins, beta-lactamase inhibitors, natural penicillins, and the penicillinase resistant penicillins.

Common antibiotics in the penicillin class include:

Generic Brand Name Examples

amoxicillin

Amoxil
amoxicillin and clavulanate Augmentin, Augmentin ES-600, Augmentin XR
ampicillin Unasyn
dicloxacillin Dynapen (discontinued)
oxacillin Bactocill (discontinued)
penicillin V potassium PC Pen VK (discontinued)

Certain penicillinase-resistant penicillins (such as oxacillin or dicloxacillin) are inherently resistant to certain beta-lactamase enzymes by themselves. Others, for example, amoxicillin or ampicillin have greater antibacterial activity when they are combined with a beta-lactamase inhibitor like clavulanate, sulbactam, or tazobactam.

View all penicillin drugs

2. Tetracyclines

Tetracyclines are broad-spectrum against many bacteria and treat conditions such as acne, urinary tract infections (UTIs), intestinal tract infections, eye infections, sexually transmitted diseases, periodontitis (gum disease), and other bacterial infections. The tetracycline class contains drugs such as:

Generic Brand Name Examples

demeclocycline

Declomycin

doxycycline

Adoxa, Doryx, Doxy 100, Oracea, Vibramycin
eravacycline Xerava
minocycline Dynacin, Minocin, Solodyn

omadacycline

Nuzyra
tetracycline  Panmycin, Sumycin

View all tetracycline drugs

3. Cephalosporins

There are five generations of cephalosporins, with increasing expanded coverage across the class to include gram-negative infections. Newer generations with updated structures are developed to allow wider coverage of certain bacteria. Cephalosporins are bactericidal (kill bacteria) and work in a similar way as the penicillins. Cephalosporins treat many types of infections, including strep throat, ear infections, urinary tract infections, skin infections, lung infections, and meningitis. Common medications in this class include:

Generic Brand Name Examples
cefaclor Ceclor (brand discontinued)
cefdinir Omnicef (discontinued)
cefotaxime Claforan
ceftazidime Avycaz, Fortaz, Tazicef
ceftriaxone Rocephin (discontinued)
cefuroxime Zinacef

The fifth generation (or next generation) cephalosporin known as ceftaroline (Teflaro) is active against methicillin-resistant Staphylococcus aureus (MRSA). Avycaz contains the the beta-lactamase inhibitor avibactam. 

View all cephalosporin drugs

4. Quinolones

The quinolones, also known as the fluoroquinolones, are a synthetic, bactericidal antibacterial class with a broad-spectrum of activity. The quinolones can be used for difficult-to-treat urinary tract infections when other options are aren’t effective, hospital-acquired pneumonia, bacterial prostatitis, and even anthrax or plague.

The FDA has issued several strong warnings about this class due to potential disabling side effects. Learn More: Fluoroquinolone Antibacterial Drugs for Systemic Use: Drug Safety Communication - Warnings Updated Due to Disabling Side Effects

Common drugs in the fluoroquinolone class include:

Generic Brand Name Examples
ciprofloxacin Cipro, Cipro XR
levofloxacin Levaquin
moxifloxacin Avelox

Several quinolones are also available in drop form to treat eye or ear infections.

View all quinolone drugs

5. Lincomycins

This class has activity against gram-positive aerobes and anaerobes (bacteria that can live without oxygen), as well as some gram-negative anaerobes. The lincomycin derivatives may be used to treat serious infections like pelvic inflammatory disease, intra-abdominal infections, lower respiratory tract infections, and bone and joint infections. Some forms are also used topically on the skin to treat acne. These drugs include:

Generic Brand Name Examples
clindamycin Cleocin, Cleocin T, Evoclin
lincomycin Lincocin

View all lincomycin drugs

6. Macrolides

The macrolides can be use to treat community-acquired pneumonia, pertussis (whooping cough), or for uncomplicated skin infections, among other susceptible infections. Ketolides are a newer generation of antibiotic developed to overcome macrolide bacterial resistance. Frequently prescribed macrolides are:

Generic Brand Name Examples
azithromycin Zithromax
clarithromycin Biaxin
erythromycin E.E.S., Ery-Tab, Eryc 

View all macrolide drugs

7. Sulfonamides

Sulfonamides are effective against some gram-positive and many gram-negative bacteria, but resistance is widespread. Uses for sulfonamides include urinary tract infections (UTIs), treatment or prevention of pneumocystis pneumonia, or ear infections (otitis media). Familiar names include:

Generic Brand Name Examples
sulfamethoxazole and trimethoprim

Bactrim, Bactrim DSSeptra

sulfasalazine Azulfidine
sulfisoxazole (product discontinued) Eryzole (discontinued), Gantrisin (discontinued)

View all sulfonamides drugs

8. Glycopeptide Antibiotics

Members of this group may be used for treating methicillin-resistant staphylococcus aureus (MRSA) infections, complicated skin infections, C. difficile-associated diarrhea, and enterococcal infections such as endocarditis which are resistant to beta-lactams and other antibiotics. Common drug names include:

Generic Brand Name Examples
dalbavancin Dalvance
oritavancin Orbactiv
telavancin Vibativ
vancomycin Firvanq, Vancocin

View all glycopeptide drugs

9. Aminoglycosides

Aminoglycosides inhibit bacterial synthesis by binding to the 30S ribosome and act rapidly as bactericidal antibiotics (killing the bacteria). These drugs are usually given intravenously (in a vein through a needle). Common examples in this class are:

Generic Brand Name Examples

gentamicin

Garamycin (discontinued), Genoptic
tobramycin TOBI, Tobradex, Tobrex
amikacin Amikin

View all aminoglycoside drugs

10. Carbapenems

These injectable beta-lactam antibiotics have a wide spectrum of bacteria-killing power and may be used for moderate to life-threatening bacterial infections like stomach infections, pneumonias, kidney infections, multidrug-resistant hospital-acquired infections and many other types of serious bacterial illnesses. They are often saved for more serious infections or used as "last-line" agents to help prevent resistance. Members of this class include:

Generic Brand Name Examples
imipenem and cilastatin Primaxin
meropenem Merrem
doripenem Doribax (discontinued)
ertapenem Invanz

View all carbapenems drugs

Are There Any Over-the-Counter Antibiotics?

Over-the-counter (OTC) oral antibiotics are not approved in the U.S. A bacterial infection is best treated with a prescription antibiotic that is specific for the type of bacteria causing the infection. Using a specific antibiotic will increase the chances that the infection is cured and help to prevent antibiotic resistance. In addition, a lab culture may need to be performed to pinpoint the bacteria and to help select the best antibiotic. Taking the wrong antibiotic -- or not enough -- may worsen the infection and prevent the antibiotic from working the next time.

There are a few over-the-counter topical antibiotics that can be used on the skin. Some products treat or prevent minor cuts, scrapes or burns on the skin that may get infected with bacteria. These are available in creams, ointments, and even sprays.

Common OTC topical antibiotics:

There are some OTC antibacterials for treating acne, too. They contain the antibacterial benzoyl peroxide, which also has mild drying effect for acne. Many products are found on the pharmacy shelves as gels, lotions, solutions, foams, cleaning pads, and even facial scrubs.

Common OTC antibacterials for acne:

See Also

Sources

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Hide