Monday, 4 Dec 2023

Which Antibiotics Are Less Likely To Cause Diarrhea From C. diff? – GoodRx

The winners

These antibiotics are rarely associated with C. diff diarrhea.

Doxycycline (Oracea)

Doxycycline (Oracea, Vibramycin) is an antibiotic prescribed for a wide variety of medical conditions including Lyme disease, bacterial sinusitis, chlamydia, rosacea, and acne. Studies on doxycycline show that the drug causes nausea and upset stomach in only 8% of folks who take it. Moreover, doxycycline monohydrate is easier on the stomach than doxycycline hyclate, and they’re essentially the same antibiotic, just attached to different types of salt.

Minocycline (Solodyn)

Minocycline (Solodyn, Minocin) and doxycycline belong to a class of antibiotics known as tetracyclines, which means they work in similar ways. Minocycline, though, is less often used. It’s primarily prescribed to treat acne and STD infections.

Metronidazole (Flagyl)

Metronidazole (Flagyl) is an antibiotic that is actually used to treat C. diff diarrhea. Think of metronidazole as an antibiotic for infections from the waist down: STDs, pelvic inflammatory disease (PID), bacterial vaginosis, and C. diff.

Second place

These antibiotics are better than the worst when it comes to C. diff, but aren’t as good as the winners.

Azithromycin (Zithromax, Z-Pak)

Azithromycin (Zithromax, Z-pak) has many uses including sinusitis, strep throat, chlamydia, H. pylori stomach infections, among others. It’s the jack-of-all-trades antibiotic, and very few bacteria are resistant to it, making it a popular choice.

Clarithromycin (Biaxin)

Clarithromycin (Biaxin), like azithromycin, is used for a number of illnesses including bacterial infections of the lung airways, sinuses, and skin. Interesting note: 10% of you taking it may notice a metallic taste in your mouth as a side effect.

Sulfamethoxazole/trimethoprim (Bactrim)

Sulfamethoxazole/trimethoprim (Bactrim) is most often prescribed for urinary tract infections, skin and soft tissue infections from MRSA, and traveler’s diarrhea. While C. diff diarrhea isn’t of great concern here, if you had a UTI in the last three months and used sulfamethoxazole/trimethoprim to treat it, you’ll want to choose a different antibiotic the second time around.

The losers

These antibiotics are frequently associated with C. diff diarrhea.


Quinolones are a class of broad -spectrum antibiotics, which means they fight many different kinds of bacteria, and they’re fairly convenient, as they generally need to be taken only once a day. But, quinolones are more likely to cause C. diff than other antibiotics.

Fluoroquinolones include popular drugs like levofloxacin (Levaquin), ciprofloxacin (Cipro), and moxifloxacin (Avelox), commonly used to treat bacterial sinusitis, urinary tract infections, and community-acquired pneumonia.

Clindamycin (Cleocin)

Clindamycin is cheap and has been around forever. It treats a variety of infections, including MRSA (methicillin-resistant Staph Aureus) skin infections and vaginal infections, but it’s a known culprit in C. diff diarrhea.


Cephalosporins are another class of antibiotics that frequently cause C. diff diarrhea. The class includes drugs like cefdinir (Omnicef), cefuroxime (Ceftin), and cefixime (Suprax), which are broad-spectrum antibiotics used for bacterial pharyngitis (throat infection), sinusitis, and ear infections.

Hope this helps.

Dr O.

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