What is the treatment for measles (rubeola) with secondary bacterial infection, using antibiotics?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: March 6, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

Antibiotics should only be used to treat secondary bacterial infections in patients with measles, not the measles virus itself. Measles is a viral infection, and antibiotics are ineffective against viruses 1. The primary treatment for measles involves supportive care to manage symptoms, including rest, adequate fluid intake to prevent dehydration, and medications like acetaminophen or ibuprofen to reduce fever and discomfort.

Key Considerations

  • Vitamin A supplements are recommended for children with measles, as they can help reduce the severity of the illness and prevent complications.
  • In severe cases or for patients with compromised immune systems, hospitalization may be necessary.
  • The best approach to measles is prevention through vaccination with the MMR (measles, mumps, rubella) vaccine.
  • If someone is exposed to measles and has not been vaccinated, receiving the vaccine within 72 hours of exposure may provide some protection or reduce the severity of the disease.

Secondary Bacterial Infections

In cases where a secondary bacterial infection develops, such as pneumonia or ear infections, antibiotics may be prescribed 1. For example, children with measles complications, such as acute lower respiratory infection (ALRI), should be administered standard treatment, including antibiotics.

Treatment Approach

The treatment approach for measles with secondary bacterial infection should prioritize the use of antibiotics only for the bacterial infection, while continuing to provide supportive care for the measles symptoms. It is essential to note that antibiotics should not be used as a preventative measure or to treat the measles virus itself, but rather to address specific bacterial complications that may arise 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Treatment for Measles with Secondary Bacterial Infection

The treatment for measles (rubeola) with secondary bacterial infection involves the use of antibiotics to manage the bacterial infection. According to 2, patient management mainly involves supportive therapy, such as vitamin A supplementation, monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhea.

Use of Antibiotics

The use of antibiotics in the treatment of measles with secondary bacterial infection is supported by several studies. A review of seven trials with 1263 children found that the incidence of pneumonia was lower in the treatment group compared to the control group, although the difference was not statistically significant 3. However, the review suggested a beneficial effect of antibiotics in preventing complications such as pneumonia, purulent otitis media, and tonsillitis in children with measles.

Common Bacterial Infections

Measles-associated pneumonia (MAP) is often caused by coinfection with other microbes, including Streptococcus pneumoniae, adenovirus, and parainfluenza viruses 4. The use of antibiotics in the treatment of MAP is crucial to prevent complications and reduce mortality.

Prevention and Treatment

While antibiotics are used to treat secondary bacterial infections, prevention of measles through vaccination is the most effective way to eliminate the disease 5, 2. Vitamin A supplementation is also recommended to prevent complications and reduce mortality 2. Additionally, passive immunity, such as the use of antibodies, can be used to prevent and treat infectious diseases, including measles 6.

Key Points

  • Antibiotics are used to treat secondary bacterial infections in measles patients
  • The use of antibiotics can prevent complications such as pneumonia, purulent otitis media, and tonsillitis
  • Measles-associated pneumonia is often caused by coinfection with other microbes
  • Prevention of measles through vaccination is the most effective way to eliminate the disease
  • Vitamin A supplementation is recommended to prevent complications and reduce mortality

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Measles.

Lancet (London, England), 2022

Research

Antibiotics for preventing complications in children with measles.

The Cochrane database of systematic reviews, 2013

Research

Coinfection is common in measles-associated pneumonia.

The Pediatric infectious disease journal, 1998

Research

Measles pneumonitis.

Advances in respiratory medicine, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.