Approximately 12 million patients present with acute pharyngitis in the USA annually. Most episodes are viral; however, Group A streptococcus (GAS) is an important and treatable infection (Snow V, Mottur-Pilson C, Cooper RJ, et al., Ann Intern Med 2001;134:506). Group A streptococcus (GAS) is the most common bacterial etiology of acute pharyngitis and accounts for 15–30% of pharyngeal infections in children and 5–20% in adults. The goal of treatment is to reduce the duration and severity of symptoms, as well as reduce complications and transmission. Antimicrobial therapy is recommended for patients with a high index of suspicion for GAS pharyngitis or when it is confirmed by culture or rapid antigen detection testing (RADT). Overtreatment of acute pharyngitis is a major cause of inappropriate antibiotic use and can be avoided by using a systematic approach to evaluation and treatment (Snow V, Mottur-Pilson C, Cooper RJ et al., Ann Intern Med 2001;134:506.).