Treatment of Scarlet fever

Scarlet fever is usually of mild intensity and goes away on its own in about a week without treatment. Scarlet fever is caused by Group A beta haemolytic Streptococci. In mild cases this might not cause complications but in severe infections there might be life threatening complications.

Thus, treatment of scarlet fever with antibiotics is important to prevent complications. Most people recover around four to five days after starting treatment with antibiotics. 1-8

Treatment of scarlet fever entails taking antibiotics, bed rest and so forth.


Usually a 10 day course of antibiotics are prescribed. Penicillin is the commonest drug of choice. Those who are allergic to penicillin may be prescribed alternatives like Erythromycin.

These days a culture and sensitivity test is done from the throat swab sample. This shows sensitivity of the stain of Streptococci to particular antibiotics. Those found effective are prescribed.

Symptoms usually go in a few days if the antibiotics are taken regularly. The fever will normally disappear within a day or two of starting antibiotics. However, all patients are advised to strictly complete their antibiotic regimen.

Bed rest

Patient is advised to stay in bed and drinking plenty of cool (not cold) fluids like water. Warm liquids like soup or cold foods like popsicles or milkshakes also help relieve a sore throat. The room needs to be kept cool.

Relieving the fever and itching

Paracetamol/Acetaminophen is prescribed to relieve the fever and to ease the aches and pains.

A calamine lotion or other soothing lotions are prescribed to relieve itching of the rash

Complications of scarlet fever

Complications of scarlet fever include:

  • ear infections (otitis media)

  • adenitis or throat abscesses

  • inflammation and infections of the sinuses (sinusitis)

  • kidney infections (glomerulonephritis)

  • lung infections (pneumonia)

acute rheumatic fever that may cause joint pain and also affect the heart valves

These complications are usually seen if scarlet fever or streptococcal sore throat is not treated adequately with antibiotics. They need to be individually assessed and appropriately managed.

Rare complications include kidney failure, meningitis, severe toxic shock or blood poisoning or infection of the deeper tissues (necrotizing fasciitis) and bones (osteomyelitis).

Those with complications or with difficulty in swallowing may need hospitalization for intravenous antibiotics and fluids.

Prevention of scarlet fever

Prevention of scarlet fever entails:

  • Scarlet fever is highly contagious. It can spread through inhaled air borne tiny droplets with the bacteria or by touching. Children with scarlet fever need to be kept away from school and day care at least till their symptoms recede.

  • Tissues and handkerchiefs used by an infected person should be disposed or washed carefully.

  • Hand washing before and after touching infected tissues or material or after touching face or nose of an infected person is important. Toys and surfaces should be washed and disinfected daily.

  • Utensils, clothes, towels, baths etc. should not be shared with an infected person.

  • Throat cultures may be needed for the family. Usually the infection can spread to others in the family. Usually repeat throat cultures are not necessary after completion of a course of antibiotics.

Scarlet fever and pregnancy

Pregnant women usually do not carry a risk of passing on any harmful effects to their unborn babies if they get this infection. However, care must be taken to isolate pregnant women and the elderly from people and children with the infections.

Adults and children over 10 rarely get Streptococcal throat infections but may be carriers of the infection.

Further Reading

Last Updated: Aug 23, 2018



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