The treatment of acute pharyngitis is mainly aimed at the prevention of complications, particularly rheumatic fever. To reach this objective group A beta-haemolytic streptococci must be eradicated. To be effective, antibiotics must penetrate into the pharyngeal and tonsillar tissues and be active against streptococci. Penicillin is effective if administered by intramuscular injection or administered orally for not less than 10 days. In practice, however, compliance with this treatment is insufficient, resulting in numerous bacteriological failures. A possible improvement in the effectiveness of treatment consists in the use of a first-generation cephalosporin with a prolonged half-life, taken daily for 10 days. Acute pharyngitis is an excellent indication for macrolides. In order to improve compliance, short treatments are being tested with promising results, but until studies on new therapeutic approaches have been completed, and in the present absence of rheumatic fever epidemics in France, acute pharyngitis must be treated systematically.