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In its first update in 10 years, the Infectious Diseases Society of America (IDSA) issued revised guidelines for the diagnosis and treatment of Group A streptococcal (GAS) pharyngitis.
To establish the diagnosis, testing is not indicated in patients with features highly suggestive of a viral cause (rhinorrhea, cough, oral ulcers, overt viral features) or in children younger than 3 years. Because clinical features inadequately discriminate between viral and GAS pharyngitis in all other cases, a rapid antigen detection test (RADT) should be performed. No treatment is recommended for patients with negative RADT results, with the exception of children and adolescents, who should have a culture performed to guide treatment. Antistreptococcal anti…