Azithromycin for scarlet fever and strep swab question.

[AmalFish]

Hello,
My DS has had the flu over the last week, he was getting some weird symptoms and I was worried so visited a paediatrician who prescribed azithromycin (5 days) for suspected scarlet fever (he thinks he may have flu and SF at the same time). The swab he took before prescribing the antibiotics have since come back negative. My Ds thankfully has been improving over the week altho he still has a white coating on his tongue and a rough rash. I have two questions-

1. if the swab culture came back negative could it be that he never had scarlet fever and maybe his weird symptoms (like the rash) were due to the flu
2. everything i’ve read suggests penicillin is the normal course for SF- i’m worried that we used a different type of antibiotics and whether it dealt with the SF properly and the potential risk of rhuematic fever if it didn’t - i guess i’m wondering if anyone has had a similar experience.?

thank you!!

Scarlet fever can be treated with either. Azizthromycin would also be given if the person was allergic to penicillin.

If he had a negative swab, scarlet fever is much less likely especially with something else detected. All viruses can give you weird skin stuff, pretty much.

The scarlet fever bacterium is very widely sensitive, penicillins tend to be preferred because they are narrow-spectrum, but azithromycin is a recognised second choice (in allergies, and some people like it in children because the number of doses ends up being much less).

Long-term complications of strep infections are almost always connected to having large numbers of untreated infections, rather than a one-off (but we over treat to try and reduce the amount circulating, if that makes sense).

Scarlet fever is caused by strep a which is what they swab for. It is then sent to a lab and the bacteria has to grow, its not a rapid test .
I think the fact he is improving is the main thing .