From the FDA Drug Label
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 treatment for scarlet fever, which is caused by Streptococcus pyogenes, is amoxicillin. The recommended duration of treatment is at least 10 days to prevent the occurrence of acute rheumatic fever 1.
From the Research
Scarlet fever is treated primarily with antibiotics, specifically penicillin or amoxicillin for 10 days, as this approach has been shown to reduce the risk of complications and morbidity, as noted in a study from 2. The treatment of scarlet fever involves the use of antibiotics to kill the Group A Streptococcus bacteria causing the infection.
- The standard dose for children is typically amoxicillin 50 mg/kg/day divided into three doses (maximum 1500 mg/day) or penicillin V 250 mg for children under 27 kg and 500 mg for those over 27 kg, taken 2-3 times daily, as discussed in 3.
- Adults usually receive penicillin V 500 mg twice daily or amoxicillin 500 mg three times daily.
- For those allergic to penicillin, alternatives include clindamycin, azithromycin, or clarithromycin, as mentioned in 4. Completing the full course of antibiotics is essential even if symptoms improve quickly, as this prevents complications like rheumatic fever and kidney inflammation, as highlighted in 5. Supportive care includes:
- Rest
- Increased fluid intake
- Acetaminophen or ibuprofen for fever and pain
- Soothing gargles for sore throat Patients remain contagious until they've been on antibiotics for 24 hours, so they should stay home during this period, as noted in 2. The antibiotics work by killing the Group A Streptococcus bacteria causing the infection, which produces the toxin responsible for the characteristic rash and other symptoms of scarlet fever, as discussed in 6.