The decision of which is more effective, levofloxacin or roxithromycin, depends on the type of infection the patient has and they are not in the same class of drugs. Levofloxacin belongs to the quinolone class of antimicrobial drugs and is mainly used to treat or prevent infections that have been proven or highly suspected to be caused by sensitive bacteria. It has a wide antibacterial spectrum and is effective against both Gram-positive and Gram-negative bacteria, and can be used to treat mild, moderate, and severe infections caused by sensitive strains of bacteria in adults, such as pneumonia, bronchitis, skin and soft tissue infections. Roxithromycin belongs to the class of macrolide antimicrobial drugs, which is mainly used for the treatment of infections caused by the sensitive strains of roxithromycin, such as tonsillitis, pharyngitis, bronchitis, impetigo, nongonococcal urethritis and so on. In addition, Roxithromycin is also used in the treatment of Mycoplasma pneumonia, Chlamydia trachomatis infection and Legionnaires’ disease. Levofloxacin and Roxithromycin have different antibacterial activity and antibacterial spectrum, so it is difficult to compare which one is more effective. Taken together, levofloxacin has a stronger antibacterial effect on the urinary tract, and roxithromycin has a stronger antibacterial effect on the respiratory tract. Patients should take targeted medication under the guidance of a doctor, do not blindly use medication.