Practice Guidelines for the Diagnosis and Management of Group A

The objective of this practice guideline is to provide recommendations for the accurate diagnosis and op-timal treatment of group A streptococcal pharyngitis in children and adults. The desired outcomes are prevention of acute rheumatic fever, prevention of suppurative compli-cations, improvement of clinical symptoms and signs, reduction in transmission of group A b-hemolytic streptococci to close contacts of patients, and minimization of potential adverse effects of in-appropriate antimicrobial therapy. This statement is an update of the practice guideline published in 1997 [1] and takes into account relevant research published since that time. A major substantive change is the acceptance of negative results of rapid antigen detection testing (RADT) for exclusion of acute streptococcal pharyngitis, without the previously man-dated confirmation with a negative culture result, pro-vided certain criteria are met, as detailed below. Diagnosis. Acute pharyngitis is one of the most frequent illnesses for which pediatricians, internists, and other primary care physicians are consulted. Al-though the group A streptococcus is the most commo