GAS pharyngitis

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Group A Streptococcus is susceptible to penicillin and treatment is indicated to prevent acute rheumatic fever and suppurative complications.

Group A Streptococcus is a relatively common cause of pharyngitis in children. Treatment is indicated for prevention of acute rheumatic fever as well as suppurative complications such as peritonsillar abscess.

Treatment is with amoxicillin (a unique dosage of 50mg/kg daily for 10 days), Penicillin V or a single dose of IM Penicillin G. GAS has never been documented to be resistant to PCN. Interesting thoughts on why this may be the case are here

Children can return to school 12 hours after initiation of antimicrobial therapy if they are feeling well enough to attend.


Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, Martin JM, Van Beneden C; Infectious Diseases Society of America. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012 Nov 15;55(10):e86-102. PMID:22965026.

American Academy of Pediatrics. Group A Streptococcal infections. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018 Report of the Committee on Infectious Diseases. American Academy of Pediatrics; 2018;