Scarlet Fever Treatment & Management: Approach Considerations, Medical Care, Prevention
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Scarlet Fever Treatment & Management
Penicillin (or amoxicillin) remains the drug of choice (documented cases of penicillin-resistant group A streptococcal infections still do not exist). A first-generation cephalosporin may be an effective alternative, as long as the patient does not have any documented anaphylactic reactions to penicillin. If this is the case, clindamycin or erythromycin may be considered as an alternative. [25, 26] However, some strains of group A streptococci may not be susceptible to macrolides. [27] Hence, in this situation, it is crucial to contact the microbiology laboratory with regard to the sensitivity of the organism to macrolide antibiotics. A 10- to 14-day course of treatment is usually recommended, and clinical improvement should be noted after 24-48 hours of antibiotic initiation.
At this time, a vaccine for group A streptococci does not exist. [28] To minimize contagion, children with scarlet fever should not return to school or daycare until they have completed 24 hours of antibiotic therapy and are clinically improving.