From the Guidelines
The recommended treatment for an 18-year-old diagnosed with scarlet fever is a full course of antibiotics, typically penicillin or amoxicillin, to reduce symptom duration and prevent serious complications like rheumatic fever or kidney inflammation. For patients not allergic to penicillin, oral penicillin V 500 mg twice daily for 10 days or amoxicillin 500 mg three times daily for 10 days is the standard regimen, as supported by the Infectious Diseases Society of America guidelines 1.
Key Considerations
- For those with penicillin allergy, alternatives include erythromycin 500 mg four times daily for 10 days, azithromycin 500 mg on day one followed by 250 mg daily for 4 more days, or clindamycin 300 mg three times daily for 10 days, as outlined in the guidelines 1.
- It's crucial to complete the entire antibiotic course even if symptoms improve quickly, to ensure eradication of the group A Streptococcus bacteria.
- Supportive care includes acetaminophen or ibuprofen for fever and throat pain, plenty of fluids, rest, and using a humidifier to ease throat discomfort.
- The patient should stay home from work or school for at least 24 hours after starting antibiotics to prevent spreading the infection.
Rationale
The American Heart Association also recommends penicillin as the treatment of choice for group A Streptococcus infections, including scarlet fever, due to its cost-effectiveness, narrow spectrum of activity, and long-standing proven efficacy 1. Given that no clinical isolate of group A Streptococcus has been documented to be resistant to penicillin, it remains the first-line treatment option 1. Overall, prompt and complete treatment with antibiotics is essential to manage scarlet fever effectively and prevent potential complications.
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 mg to 250 mg (200,000 to 400,000 units) every 6 to 8 hours for 10 days The recommended treatment for an 18-year-old diagnosed with scarlet fever is penicillin (PO), with a dosage of 125 mg to 250 mg every 6 to 8 hours for 10 days 2.
- The dosage may vary depending on the severity of the infection and the patient's clinical response.
- It is essential to follow the prescribed dosage and treatment duration to ensure effective treatment of the infection.
From the Research
Treatment Overview
The recommended treatment for an 18-year-old diagnosed with scarlet fever involves the use of antibiotics to reduce the risk of complications and the spread of infection.
Antibiotic Treatment
- The use of phenoxymethylpenicillin (Penicillin V) is recommended as a suitable antibiotic for treating scarlet fever, as stated in the study 3.
- Another study 4 compared the effectiveness of a shortened 5- to 7-day antibiotic regimen with the classic 10-day regimen for acute streptococcal pharyngotonsillitis and found similar outcomes, suggesting that a shorter course may be effective.
- The application of penicillin therapy early in the treatment of scarlet fever and prolonging it in the recovery period can decrease the number of early and late complications, as well as reduce the number of carriers of beta-haemolytic streptococcus, as shown in the study 5.
Considerations
- While the studies provide guidance on antibiotic treatment, the specific treatment regimen may vary depending on individual patient needs and circumstances.
- It is essential to follow the prescribed antibiotic course as directed by a healthcare professional to ensure effective treatment and minimize the risk of complications.
- The study 6 discusses the treatment of rheumatic fever, a potential complication of streptococcal infection, but its findings may not be directly applicable to the treatment of scarlet fever in an 18-year-old.
- The study 7 compares the merits of 3-week versus 4-week benzathine penicillin prevention programs for rheumatic fever recurrences, which may not be relevant to the treatment of scarlet fever.