HE ARGUMENTS PUT FORTH FOR antibacterial treatment of pharyngitis caused by group A streptococcus (GAS) include relief of acute symptoms, prevention of rheumatic fever and suppurative complications, and reduced spread of disease. Treatment of suspected GAS pharyngitis at the time of initial clinical evaluation has a modest effect on acute symptoms and perhaps suppurative complications. 1 However, antibacterial treatment may be delayed for several days and still achieve the goal of preventing rheumatic fever and spread of disease. Due to the nonspecific clinical features of GAS pharyngitis, authorities have generally recommended laboratory confirmation of the presence of GAS before treatment in order to limit unnecessary antibiotic treatment of patients with GAS-negative sore throats. 2 Recent guidelines from the Infectious Diseases Society of America (IDSA) reiterate 2 principles of management in cases of sore throat: (1) use of clinical and epidemiologic features to distinguish patients who may have GAS pharyngitis; and (2) antibacterial Author Affiliations are listed at the end of this article.