From the FDA Drug Label
The usual dosage recommendations for adults and children 12 years and over are as follows: Streptococcal Infections Mild to moderately severe - of the upper respiratory tract and including scarlet fever and erysipelas: 125 to 250 mg (200,000 to 400,000 units) every 6 to 8 hours for 10 days It is recommended that there be at least 10 days’ treatment for any infection caused by Streptococcus pyogenes to prevent the occurrence of acute rheumatic fever.
The recommended treatment for scarlet fever is penicillin V (PO) with a dosage of 125 to 250 mg (200,000 to 400,000 units) every 6 to 8 hours for 10 days 1. Alternatively, amoxicillin (PO) can be used with a treatment duration of at least 10 days to prevent the occurrence of acute rheumatic fever 2 2. Key points to consider:
- The treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic, or evidence of bacterial eradication has been obtained.
- The dosage may vary depending on the severity of the infection and the patient's age and weight.
From the Research
The recommended treatment for scarlet fever is antibiotics, specifically penicillin, which should be taken for a full course to reduce the risk of complications and the spread of infection. According to the most recent and highest quality study 3, patients who have the typical symptoms of scarlet fever should be prescribed a suitable antibiotic such as phenoxymethylpenicillin (Penicillin V) immediately.
Key Considerations
- The treatment should be initiated as soon as possible to prevent complications and reduce the spread of infection.
- Penicillin is the preferred antibiotic for treating scarlet fever, as it is effective against Group A Streptococcus bacteria that cause the disease.
- Patients with penicillin allergies can be treated with alternatives, but the choice of antibiotic should be guided by susceptibility patterns and clinical judgment.
Supportive Care
- Alongside antibiotics, supportive care includes measures to manage symptoms such as fever and discomfort, prevent dehydration, and promote rest.
- Acetaminophen or ibuprofen can be used to manage fever and discomfort, and patients should be encouraged to drink plenty of fluids to stay hydrated.
- Rest is also important to help the body recover from the infection.
Prevention of Complications
- Completing the full antibiotic course is crucial to completely eliminate the Group A Streptococcus bacteria that cause scarlet fever, preventing complications like rheumatic fever or kidney inflammation.
- Patients are typically no longer contagious after 24 hours of antibiotic treatment, but should stay home from school or work until fever-free for at least 24 hours to prevent the spread of infection.
- Prompt treatment reduces symptom duration and prevents spread to others, highlighting the importance of early diagnosis and treatment.