What is the treatment for Scarlet fever (Scarlatina)?

From the Guidelines

Scarlett fever should be treated primarily with antibiotics, specifically penicillin or amoxicillin, to reduce morbidity, mortality, and improve quality of life. The treatment guidelines for Scarlett fever are largely based on the management of Group A Streptococcus infections, as seen in the Pediatric Community Pneumonia Guidelines 1.

Key Considerations

• The standard dosage for children is amoxicillin 50 mg/kg/day divided into three doses for 10 days, as per the guidelines for Group A Streptococcus treatment 1.
• For patients with penicillin allergies, alternatives include clindamycin, azithromycin, or clarithromycin, although the specific dosage may vary.
• Treatment should begin promptly after diagnosis to prevent complications, such as rheumatic fever and kidney inflammation, and reduce contagiousness.

Supportive Care

• Supportive care includes acetaminophen or ibuprofen for fever and discomfort, plenty of fluids to prevent dehydration, and rest.
• The throat pain can be managed with warm salt water gargles or throat lozenges.
• Patients remain contagious until they've been on antibiotics for 24 hours and should stay home during this period.

Antibiotic Therapy

• Antibiotics work by killing the Group A Streptococcus bacteria causing the infection, preventing serious complications and the spread of infection to others.
• The choice of antibiotic and dosage should be guided by the most recent and highest-quality evidence, such as the Pediatric Community Pneumonia Guidelines 1.

From the Research

Treatment for Scarlet Fever

There are no specific details on the treatment for Scarlet fever in the provided study 2. However, the study does mention the importance of timely treatment and the potential consequences of delayed diagnosis.

Key Findings

• The study found that scarlet fever may be initially overlooked, especially among older children presenting with sore throat 2.
• Delay in diagnosis beyond first consultation occurred more frequently among children aged 5+ who presented with sore throat 2.
• Cases with delayed diagnosis took, on average, 1 day longer to return to baseline activities 2.

Management and Diagnosis

• Rash was reported for 89% of cases, but followed onset of other symptoms for 71%, with a median 1-day delay 2.
• At first consultation, for 28%, scarlet fever was not considered: in these cases, symptoms were frequently attributed to viral infection 2.

Epidemiology

• The study characterized the epidemiology, symptoms, management and consequences of scarlet fever in London, 2018-2019 2.
• Median age was 4 years (range <1 to 16), 48% were female, and 70% were of white ethnicity 2.