First-line therapy for scarlet fever is?

First-line therapy for scarlet fever is?

• A. Azithromycin
• B. Doxycycline
• C. Cephalexin
• D. Penicillin G or Penicillin VK

Answer: (D)

Scarlet fever is caused by group A Streptococcus, which is universally susceptible to penicillin. Using penicillin G (IM) or penicillin VK (oral) reliably eradicates the organism from the throat, reduces contagiousness, and prevents serious complications like rheumatic fever. Penicillin remains first-line because of its proven efficacy, safety, low cost, and narrow spectrum that minimizes impact on normal flora. Alternatives such as macrolides (for penicillin allergy) or doxycycline (not used in children) exist, but penicillin is preferred when there is no allergy. Cephalexin can be used in some penicillin-allergic patients, but it’s not the preferred first-line choice due to broader spectrum considerations and cross-reactivity concerns.

Scarlet fever is caused by group A Streptococcus, which is universally susceptible to penicillin. Using penicillin G (IM) or penicillin VK (oral) reliably eradicates the organism from the throat, reduces contagiousness, and prevents serious complications like rheumatic fever. Penicillin remains first-line because of its proven efficacy, safety, low cost, and narrow spectrum that minimizes impact on normal flora. Alternatives such as macrolides (for penicillin allergy) or doxycycline (not used in children) exist, but penicillin is preferred when there is no allergy. Cephalexin can be used in some penicillin-allergic patients, but it’s not the preferred first-line choice due to broader spectrum considerations and cross-reactivity concerns.