Scarlet Fever (Antimicrobial)
TAM (Treatments and Medicines) NHS Highland
Warning
What's new / Latest updates
27/09/24:
- CKS link added.
- Penicillin allergy treatment updated. Including change of first line choice and options for penicillin allergy birth to 6 months of age and in pregnancy/post-partum.
12/11/24:
- additional dose information included for children over 6 months with penicillin allergy.
Prompt treatment with appropriate antibiotics significantly reduces the risk of complications. People who are at increased risk of invasive Group A streptococcal infection (iGAS) and complications include people:
- At extremes of the age range, such as the very young and old, or postpartum women.
- Who are immunocompromised, immunosuppressed, or with other comorbidities.
- With concurrent chickenpox or influenza.
- Who inject drugs or are alcohol dependent.
See Specialist Pharmacy Service for advice on using solid oral dosage form antibiotics in children.
For glossary of terms see Glossary.
Drug details
First line (mild)
Analgesia
Second line
Phenoxymethylpenicillin 500mg 4 times a day
10 days
Penicillin allergy
Azithromycin 500mg once daily
5 days
Penicillin allergy (children over 6 months)
Azithromycin 12mg/kg once daily - see BNFC for weight-banded doses
5 days
Penicillin allergy (children from birth to 6 months of age)
Clarithromycin 7.5mg/kg twice a day (as per BNFC)
10 days
Penicillin allergy (pregnancy or post-partum)
Erythromycin 500mg four times daily OR 1 gram twice daily
10 days