East Region Formulary
NHS Scotland

Scarlet fever

Treatment of scarlet fever
Phenoxymethylpenicillin
Phenoxymethylpenicillin 250mg tablets

500mg every 6 hours for 10 days

Phenoxymethylpenicillin 250mg/5ml oral solution sugar free

500mg every 6 hours for 10 days

If penicillin allergic, prescribe clarithromycin.

Clarithromycin
Clarithromycin 500mg tablets

500mg every 12 hours for 10 days

Clarithromycin 250mg/5ml oral suspension

500mg every 12 hours for 10 days

History Notes

15/12/2021

East Region Formulary content agreed.

Treatment of scarlet fever
Phenoxymethylpenicillin
Phenoxymethylpenicillin 250mg tablets

For 10 days.
1-11 months: 62.5mg 4 times daily, or 125mg twice daily.
1-5 years: 125mg 4 times daily, or 250mg twice daily.
6-11 years: 250mg 4 times daily, or 500mg twice daily.
12-17 years: 500mg 4 times daily, or 1000mg twice daily.

Phenoxymethylpenicillin 125mg/5ml oral solution sugar free

For 10 days.
1-11 months: 62.5mg 4 times daily, or 125mg twice daily.
1-5 years: 125mg 4 times daily, or 250mg twice daily.
6-11 years: 250mg 4 times daily, or 500mg twice daily.
12-17 years: 500mg 4 times daily, or 1000mg twice daily.

Phenoxymethylpenicillin 250mg/5ml oral solution sugar free

For 10 days.
1-11 months: 62.5mg 4 times daily, or 125mg twice daily.
1-5 years: 125mg 4 times daily, or 250mg twice daily.
6-11 years: 250mg 4 times daily, or 500mg twice daily.
12-17 years: 500mg 4 times daily, or 1000mg twice daily.

If penicillin allergic, prescribe clarithromycin.

Clarithromycin
Clarithromycin 250mg tablets

For 10 days.
1 month - 11 years:
(<8kg body weight) 7.5mg/kg twice daily.
(8-11kg body weight) 62.5mg twice daily.
(12-19kg body weight) 125mg twice daily.
(20-29kg body weight) 187.5mg twice daily.
(30-40kg body weight) 250mg twice daily.
12-17 years: 250-500mg twice daily.

Clarithromycin 500mg tablets

For 10 days.
1 month - 11 years:
(<8kg body weight) 7.5mg/kg twice daily.
(8-11kg body weight) 62.5mg twice daily.
(12-19kg body weight) 125mg twice daily.
(20-29kg body weight) 187.5mg twice daily.
(30-40kg body weight) 250mg twice daily.
12-17 years: 250-500mg twice daily.

Clarithromycin 125mg/5ml oral suspension

For 10 days.
1 month - 11 years:
(<8kg body weight) 7.5mg/kg twice daily.
(8-11kg body weight) 62.5mg twice daily.
(12-19kg body weight) 125mg twice daily.
(20-29kg body weight) 187.5mg twice daily.
(30-40kg body weight) 250mg twice daily.
12-17 years: 250-500mg twice daily.

Clarithromycin 250mg/5ml oral suspension

For 10 days.
1 month - 11 years:
(<8kg body weight) 7.5mg/kg twice daily.
(8-11kg body weight) 62.5mg twice daily.
(12-19kg body weight) 125mg twice daily.
(20-29kg body weight) 187.5mg twice daily.
(30-40kg body weight) 250mg twice daily.
12-17 years: 250-500mg twice daily.

Prescribing Notes:

  • A course length of 10 days of phenoxymethylpenicillin or clarithromycin is recommended for of scarlet fever. Since the reconstituted expiry date of phenoxymethylpenicillin suspension is 7 days, 2 bottles of suspension should be prescribed to be dispensed a week apart.
  • For more information refer to NICE CKS: Scarlet fever.

History Notes

15/01/2024

East Region Formulary content agreed.