Switching From Clindamycin To Azithromycin After Experiencing Diarrhea

Answer

Thanks for reaching out! Experiencing diarrhea while taking an antibiotic, especially clindamycin, is a fairly common side effect. 

In fact, among antibiotics, clindamycin is generally associated as one of the most likely ones to cause diarrhea and clinical studies involving the drug have reported the side effect in at least 20% of those taking the drug.

Clindamycin Causing Clostridium Difficile Associated Diarrhea

Now, and this is an important point, even though diarrhea with clindamycin is common, if you notice a more severe form of it, it may be due to a less common, but serious, side effect of clindamycin, a C.diff infection. 

Clostridium difficile (also known as C. diff) is a type of bacteria that can cause severe diarrhea and other digestive problems. This type of bacteria can sometimes proliferate in those who have recently taken antibiotics, especially clindamycin.

As mentioned, if you experience a more severe form of diarrhea while taking clindamycin, and you are also experiencing associated side effects, such as bloody stools, abdominal pain, cramping, fever, and loss of appetite, it is important to see a doctor as soon as possible for proper diagnosis and treatment.

You said you started experiencing diarrhea with clindamycin within 20 minutes after taking a dose, so you likely didn't have a Clostridium difficile infection. It usually only happens with prolonged use. Regardless, I thought it was an important topic to cover here.

Switching To Azithromycin

Antibiotic-associated diarrhea is typically reported as the primary reason antibiotics are discontinued. If it occurs, an alternative is generally used and azithromycin often fits the bill as an appropriate alternative (depending on what you're treating).

Even though clindamycin and azithromycin share a similar name (sharing 'mycin' at the end), and work similarly, they are in different drug classes and have different properties.

Clindamycin is classified as a 'lincosamide antibiotic' while azithromycin is a 'macrolide antibiotic' and a derivative of erythromycin.

Among their many differences, one is their overall tolerability.

Azithromycin is generally far better tolerated than clindamycin in regard to their gastrointestinal side effects.

Azithromycin can certainly still cause nausea, diarrhea, and upset stomach etc..., but generally it is less common, and less severe than clindamycin.

Does Having Diarrhea With Clindamycin Put You More At Risk?

You specifically asked in your question if there was an indicator that you will experience diarrhea on azithromycin having had the problem with clindamycin.

The answer here is that there really isn't a specific indicator unfortunately. Having experienced diarrhea with clindamycin isn't considered an indicator you will experience it with azithromycin.

Although we aren't talking about allergies here, I think it's important to bring up that most studies find that clindamycin is not thought to have a cross-reactivity risk with other antibiotics.

In other words, in those allergic to clindamycin, they don't appear to be any more at risk to having an allergic reaction to other antibiotics.

You certainly may be someone who just is more susceptible to the gastrointestinal side effects of taking prescription medication, or you could have some kind of underlying sensitivity that would be a challenge to definitively know.

Reduce The Risk & Severity Of Gastrointestinal Side Effects With Azithromycin

Although results from studies are mixed, antibiotic associated diarrhea may be due to the drugs eradicating 'good' gut bacteria. Sometimes, a probiotic supplement can help here and it may be an option for you to try.

Additionally, be sure to take the antibiotic with food. This can help as well.

Final Words

I hope this answer helped provide some of the information you were looking for!

Please feel free to reach back out again anytime.