When doctors choose an antibiotic for a respiratory infection, skin issue, or STI, they often pick from a group called macrolides, a class of antibiotics that block bacterial protein synthesis. Also known as protein synthesis inhibitors, macrolides are commonly used because they work against a broad range of bacteria and are usually well tolerated. The three big names you’ll hear are azithromycin, a once-daily antibiotic with long-lasting effects in tissues, clarithromycin, a stronger option for sinus and lung infections, and erythromycin, the original macrolide, still used when others aren’t an option. These aren’t interchangeable — each has different strengths, side effects, and best-use cases.
What makes macrolides different isn’t just the brand name. Azithromycin stays in your body for days after you stop taking it, which is why a 5-day course can treat a chest infection that other antibiotics need 10 days to clear. Clarithromycin is more potent against H. pylori, the bacteria that causes stomach ulcers, and it’s often paired with other drugs for that purpose. Erythromycin, while older, is still the go-to for people allergic to penicillin who can’t take azithromycin due to heart rhythm concerns. But here’s the catch: all macrolides can cause stomach upset, and some interact badly with heart meds or cholesterol drugs. If you’re on blood thinners or have liver issues, your doctor needs to know before prescribing any of them.
Looking at the posts on this page, you’ll find real comparisons between these drugs and others — like how azithromycin stacks up against doxycycline for chlamydia, or why clarithromycin might be preferred over amoxicillin for certain sinus infections. You’ll also see how side effects vary between patients, what dosing schedules actually look like in practice, and when a macrolide might be the wrong call altogether. This isn’t theoretical — it’s based on real prescriptions, patient reports, and clinical guidelines. Whether you’re trying to understand why your doctor picked one antibiotic over another, or you’re comparing options for a recurring infection, the posts here give you the facts without the fluff.
A deep dive comparing Roxithromycin (Rulide) with azithromycin, clarithromycin, erythromycin, levofloxacin and doxycycline, covering efficacy, dosing, side effects, cost and when to choose each.
