Paediatric

Scarlet fever

Notify the local health protection team promptly by completing a notification form if a diagnosis of scarlet fever is suspected.

Preferred

Treat for 10 days

phenoxymethyl penicillin (penicillin V)  po see dosing table

The unpleasant taste and palatability of phenoxymethyl penicillin (penicillin V) suspension can affect adherence to antibiotics, which may result in treatment failure. The use of tablets should be encouraged in children over the age of 6 years old. The healthier together team provide advice about teaching children to swallow tablets.

Age

phenoxymethyl penicillin (penicillin V) oral dose

1 month to 11 months

62.5mg QDS or 125mg BD

1 year -5 years

125mg QDS or 250mg BD

6-11 years

250mg QDS or 500mg BD

12-18 years

500mg QDS or 1g BD

 

If penicillin suspension not tolerated (palatability), use amoxicillin po, see dosing table.

Alternatively dosing of 40mg/kg (Max 1g) po BD may be used* 

Treat for 10 days

Age

amoxicillin oral dose

1 month to 11 months

125mg TDS

1 year - 4 years

250mg TDS

5 years and over 

500mg TDS

*Off-license dosing. Reference: World Health Organisation.  Recommendations for management of common childhood 2012 conditions. WHO link accessed 02/23

 

If severe or orals not tolerated: consider benzylpenicillin 50mg/kg (Max 2.4g) iv QDS

Alternative

For penicillin allergy (non-severe and severe)

azithromycin 10mg/kg (Max 500mg) po OD for 5 days

Editorial Information

Last reviewed: 19 Mar 2026

Author(s): AMST.

Approved By: MMTC