Scarlet Fever

On 14th December 2022, Scottish Antimicrobial Prescribing Group published more detailed advice on the Antibiotic Management of Group A Streptococcus infection in children aged 18 and under.  Link
A table of therapy recommendations is provided with an order of preference and includes alternative options if the first line choice is unavailable due to increased demand.  The duration of therapy has been clarified and there is a link to important safety netting advice for parents and carers.  The advice will be reviewed again in January 2023.
  • Prompt treatment with appropriate antibiotics significantly reduces the risk of complications.  Observe immunocompromised individuals (diabetes, women in puerperal period, chickenpox) as they are at increased risk of developing invasive infection.
  • 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)


Second line

Phenoxymethylpenicillin 500mg 4 times a day

10 days

In penicillin allergy

Clarithromycin 250mg to 500mg twice daily

5 days

Last reviewed: 14 November 2017

Next review: 14 November 2019

Author(s): Antimicrobial Management Team

Approved By: TAM Subgroup of ADTC

Reviewer Name(s): Area Antimicrobial Pharmacist

Document Id: AMT153