Two medicines, side by side
Azithromycin vs vancomycin
Azithromycin and vancomycin are both labeled for bacterial infections. Drugs@FDA records approvals of azithromycin since 1991 and of vancomycin since 1986. Pharmacies paid $0.266 per azithromycin 250 mg tablet and $1.33 per vancomycin HCl 125 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Azithromycin's other strengths are brand-only: $98.51 per mL (Azasite 1% eye drops). In FDA's classes, azithromycin is a macrolide antimicrobial and vancomycin a glycopeptide antibacterial.
Check it at the source: the azithromycin FDA label on DailyMed (effective December 4, 2025); the vancomycin FDA label on DailyMed (effective June 7, 2024).
Highlights of the azithromycin record
Azithromycin (Zithromax) · label of December 4, 2025
Used for
From the label: indicationsAzithromycin tablets are macrolide antibacterial drug indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the specific conditions listed below. […]
On the market
- Earliest approval on file
- November 1, 1991
- Generic labelers
- 55 labelers
- Pharmacy cost
- $0.266 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 11
Highlights of the vancomycin record
Vancomycin (Vancocin Hydrochloride) · label of June 7, 2024
Used for
From the label: indicationsVancomycin Hydrochloride for Injection is a glycopeptide antibacterial indicated in adult and pediatric patients (neonates and older) for the treatment of: • Septicemia ( 1.1 ) • Infective Endocarditis ( 1.2 ) • Skin and Skin Structure Infections ( 1.3 ) • Bone Infections ( 1.4 ) • Lower Respiratory Tract Infections ( 1.5 ) To reduce the development of drug-resistant bacteria and maintain the effectiveness of […]
On the market
- Earliest approval on file
- April 15, 1986
- Generic labelers
- 31 labelers
- Pharmacy cost
- $1.33 per capsule
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 49
Source: FDA drug labels via openFDA (Azithromycin label of December 4, 2025, Vancomycin label of June 7, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do azithromycin and vancomycin differ on the record?
In FDA's classes, azithromycin is a macrolide antimicrobial and vancomycin a glycopeptide antibacterial.
How each works, in its label's words: Azithromycin, “Azithromycin is a macrolide antibacterial drug. [see Microbiology ( 12.4 )]”; Vancomycin, “Vancomycin is an antibacterial drug [see Microbiology (12.4) ].”
Half-life, in each label's words: Azithromycin, “Elimination Plasma concentrations of azithromycin following single 500 mg oral and IV doses declined in a polyphasic …”; Vancomycin, “The mean elimination half-life of vancomycin from plasma is 4 to 6 hours in subjects with normal renal function.”
Generics: azithromycin since 2005; vancomycin since 1964 (Drugs@FDA).
| Azithromycin | Vancomycin | |
|---|---|---|
| Labeled for | Bacterial infections | Bacterial infections, Diarrhea |
| Pharmacologic class | Macrolide Antimicrobial | Glycopeptide Antibacterial |
| How it works (label) | Azithromycin is a macrolide antibacterial drug. [see Microbiology ( 12.4 )] | Vancomycin is an antibacterial drug [see Microbiology (12.4) ]. |
| Half-life (label) | Elimination Plasma concentrations of azithromycin following single 500 mg oral and IV doses declined in a polyphasic pattern resulting in a mean apparent plasma clearance of 630 mL/min and terminal elimination half-life … | The mean elimination half-life of vancomycin from plasma is 4 to 6 hours in subjects with normal renal function. |
| Earliest approval on file (Drugs@FDA) | November 1, 1991 | April 15, 1986 |
| First generic approved | November 14, 2005 | November 6, 1964 |
| Generic labelers (NDC) | 55 labelers | 31 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.266 per tablet (Azithromycin 250 mg tablet) | $1.33 per capsule (Vancomycin HCl 125 mg capsule) |
| 12-month price change | -26% | +4% |
| Boxed warning | No | No |
| Shortage now | A presentation being discontinued | A presentation being discontinued |
| Recalls recorded | 11 | 49 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 59,712 | 65,529 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to azithromycin
- every medicine labeled for the same conditions