Two medicines, side by side
Clindamycin vs azithromycin
Clindamycin and azithromycin are both labeled for bacterial infections. Drugs@FDA records approvals of clindamycin since 1970 and of azithromycin since 1991. Pharmacies paid $0.137 per gram (Clindamycin ph 1% gel) and $0.266 per azithromycin 250 mg tablet (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, clindamycin is a lincosamide antibacterial and azithromycin a macrolide antimicrobial.
Check it at the source: the clindamycin FDA label on DailyMed (effective March 10, 2026); the azithromycin FDA label on DailyMed (effective December 4, 2025).
Highlights of the clindamycin record
Clindamycin (Cleocin) · label of March 10, 2026
Clostridioides difficile -associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including clindamycin hydrochloride and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of C. difficile.
Used for
From the label: indicationsClindamycin is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. […]
On the market
- Earliest approval on file
- February 22, 1970
- Generic labelers
- 60 labelers
- Pharmacy cost
- $0.137 per gram
Supply and safety
- Shortage
- In shortage
- Recalls
- 24
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
Source: FDA drug labels via openFDA (Clindamycin label of March 10, 2026, Azithromycin label of December 4, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do clindamycin and azithromycin differ on the record?
In FDA's classes, clindamycin is a lincosamide antibacterial and azithromycin a macrolide antimicrobial.
Half-life, in each label's words: Clindamycin, “Excretion The average biological half-life is 2.4 hours.”; Azithromycin, “Elimination Plasma concentrations of azithromycin following single 500 mg oral and IV doses declined in a polyphasic …”
Only the clindamycin label carries a boxed warning.
Generics: clindamycin since 1982; azithromycin since 2005 (Drugs@FDA).
| Clindamycin | Azithromycin | |
|---|---|---|
| Labeled for | Bacterial infections, Acne | Bacterial infections |
| Pharmacologic class | Lincosamide Antibacterial | Macrolide Antimicrobial |
| How it works (label) | n/a | Azithromycin is a macrolide antibacterial drug. [see Microbiology ( 12.4 )] |
| Half-life (label) | Excretion The average biological half-life is 2.4 hours. | 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 … |
| Earliest approval on file (Drugs@FDA) | February 22, 1970 | November 1, 1991 |
| First generic approved | February 8, 1982 | November 14, 2005 |
| Generic labelers (NDC) | 60 labelers | 55 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.137 per gram (Clindamycin ph 1% gel) | $0.266 per tablet (Azithromycin 250 mg tablet) |
| 12-month price change | -10% | -26% |
| Boxed warning | Yes | No |
| Shortage now | In shortage | A presentation being discontinued |
| Recalls recorded | 24 | 11 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 8,968 | 59,712 |
| 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 clindamycin
- every medicine labeled for the same conditions