The Infectious Disease Society of America updated its guidelines for the management of group A streptococcal (GAS) pharyngitis in 2012. The key recommendations for diagnosis and treatment are outlined below. 
Diagnostic guidelines are as follows:
Rapid antigen detection test (RADT) and/or culture should be performed to distinguish between GAS and viral pharyngitis, except when overt viral features such as rhinorrhea, cough, oral ulcers, and/or hoarseness are present.
In children and adolescents, negative RADT results should be confirmed with a throat culture.
Because of the low incidence of GAS pharyngitis in adults and the exceptionally low risk of subsequent acute rheumatic fever, throat culture after a negative RADT result is unnecessary.
Treatment guidelines are as follows:
Penicillin or amoxicillin is the recommended drug of choice.
For penicillin-allergic patients, first-generation cephalosporin (for those not anaphylactically sensitive), clindamycin, clarithromycin, or azithromycin
As an adjunct to antibiotic therapy, acetaminophen or an NSAID should be considered for treatment of moderate to severe symptoms or control of high fever
Aspirin should be avoided in children
Corticosteroids are not recommended as adjunctive therapy
Tonsillectomy solely to reduce the frequency of GAS pharyngitis is not recommended
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