Can't Find Azasite? Here Are Your Alternatives

If you've been prescribed Azasite (Azithromycin ophthalmic solution 1%) for bacterial conjunctivitis and can't get it filled, you're dealing with a frustration that many patients share in 2026. Between its specialty-only distribution, no generic availability, and increased demand from the erythromycin shortage, Azasite can be genuinely difficult to locate.

But here's the good news: Azasite is not the only effective treatment for bacterial conjunctivitis. Several alternative antibiotic eye drops can treat your eye infection just as effectively — and many are more affordable and easier to find. In this guide, we'll cover what Azasite does, how it works, and the best alternatives your doctor might consider.

If you haven't given up on finding Azasite yet, check our guide: How to find Azasite in stock near you.

What Is Azasite and How Does It Work?

Azasite is a prescription eye drop containing Azithromycin 1%, a macrolide antibiotic. It works by blocking bacteria from making the proteins they need to grow and reproduce. Without these essential proteins, the bacteria die off, clearing the infection.

Azasite was approved by the FDA in 2007 specifically for bacterial conjunctivitis (pink eye). Its unique DuraSite delivery system keeps the medication on the eye surface longer, allowing for a convenient dosing schedule: twice daily for 2 days, then once daily for 5 days.

For a complete overview, see: What is Azasite? Uses, dosage, and what you need to know.

To understand the full mechanism, read: How does Azasite work? Mechanism of action explained.

Alternative #1: Moxifloxacin (Vigamox)

Moxifloxacin ophthalmic solution 0.5%, sold under the brand name Vigamox, is one of the most commonly prescribed alternatives to Azasite. It's a fluoroquinolone antibiotic — a different class than Azasite — with broad-spectrum activity against many of the same bacteria that cause conjunctivitis.

Key facts about Moxifloxacin:

• Dosing: 1 drop three times daily for 7 days
• Available in generic form
• Cost: approximately $15–$30 with a coupon for the generic version
• Available at most retail pharmacies
• Well-tolerated with minimal side effects

Moxifloxacin is often a first-choice treatment for bacterial conjunctivitis due to its availability, affordability, and effectiveness. It covers gram-positive and gram-negative bacteria and is preservative-free, making it gentler on the eyes.

Alternative #2: Tobramycin (Tobrex)

Tobramycin ophthalmic solution 0.3%, sold under the brand name Tobrex, is an aminoglycoside antibiotic that has been used for decades to treat bacterial eye infections.

Key facts about Tobramycin:

• Dosing: 1–2 drops every 4 hours for mild infections; may be used more frequently for severe infections
• Available as both drops and ointment
• Generic widely available
• Cost: approximately $10–$20 with a coupon
• Available at most retail pharmacies

Tobramycin is particularly effective against gram-negative bacteria like Pseudomonas and Haemophilus influenzae. The main downside is more frequent dosing compared to Azasite's once-daily regimen.

Alternative #3: Polymyxin B/Trimethoprim (Polytrim)

Polytrim is a combination antibiotic eye drop containing Polymyxin B and Trimethoprim. The two antibiotics work together to cover a broad range of bacteria commonly responsible for conjunctivitis.

Key facts about Polytrim:

• Dosing: 1 drop every 3 hours for 7–10 days (up to 6 drops per day)
• Generic widely available
• Cost: approximately $10–$15 with a coupon — one of the most affordable options
• Available at virtually every pharmacy

Polytrim is often recommended as a first-line treatment for bacterial conjunctivitis because of its low cost, wide availability, and reliable effectiveness. The more frequent dosing schedule is the main trade-off compared to Azasite.

Alternative #4: Erythromycin Ophthalmic Ointment

Erythromycin ophthalmic ointment 0.5% is another macrolide antibiotic — the same drug class as Azasite. It works through a similar mechanism of action and has been a standard treatment for bacterial conjunctivitis for decades.

Key facts about Erythromycin ointment:

• Dosing: Apply a thin ribbon to the affected eye 2–6 times daily
• Generic available when in stock
• Cost: approximately $15–$30 when available
• Currently in shortage — the FDA has asked providers to reserve supplies for neonatal use

Because of the ongoing erythromycin shortage, this alternative may not be available either. In fact, the erythromycin shortage is one reason Azasite demand has increased. If you can't find either, the fluoroquinolone or aminoglycoside options above are your best bet.

How to Talk to Your Doctor About Alternatives

If you can't find Azasite, contact your prescriber and let them know. Be prepared to discuss:

• Which pharmacies you've tried and what they've told you
• Whether you've checked the EyeRx Direct program at azasite.com
• Any drug allergies (especially to macrolides, fluoroquinolones, or aminoglycosides)
• Cost concerns — generics like Polytrim and Tobramycin are significantly cheaper than Azasite

Your doctor can switch your prescription quickly, often with a phone call or electronic message to the pharmacy. Don't wait — bacterial conjunctivitis should be treated promptly to prevent complications and reduce transmission.

Final Thoughts

While Azasite is an excellent antibiotic eye drop, it's far from the only option for treating bacterial conjunctivitis. Moxifloxacin, Tobramycin, and Polytrim are all proven, effective, and much more affordable and accessible in 2026. If you can't find Azasite, work with your doctor to switch to an alternative — the most important thing is getting treatment started quickly.

Use Medfinder to check pharmacy availability for Azasite or any of these alternatives near you. And for the latest on Azasite supply, read our Azasite shortage update.