Dilemmas of streptococcal pharyngitis.

Although the Group A beta-hemolytic streptococcus is the most common cause of acute bacterial pharyngitis in childhood, the clinical diagnosis is often not straightforward and throat cultures are advisable. To avoid unnecessary antibiotics, treatment should be delayed until culture results are available. Patients with negative cultures should discontinue any antibiotics already started on clinical grounds. Positive cultures may represent a carrier state, which can be identified by serologic studies.