Group A β-hemolytic Streptococcal Pharyngitis: An Updated Review

Alexander   K.C.   Leung; Joseph   M.   Lam; Benjamin      Barankin; Kin   F.   Leong; Kam   L.   Hon
doi:10.2174/1573396320666230726145436
Abstract

Background: Group A ß-hemolytic Streptococcus (GABHS) is the leading bacterial cause of acute pharyngitis in children and adolescents worldwide.
Objective: This article aims to familiarize clinicians with the clinical manifestations, evaluation, diagnosis, and management of GABHS pharyngitis.
Methods: A search was conducted in December 2022 in PubMed Clinical Queries using the key term “group A β-hemolytic streptococcal pharyngitis”. This review covers mainly literature published in the previous ten years.
Results: Children with GABHS pharyngitis typically present with an abrupt onset of fever, intense pain in the throat, pain on swallowing, an inflamed pharynx, enlarged and erythematous tonsils, a red and swollen uvula, enlarged tender anterior cervical lymph nodes. As clinical manifestations may not be specific, even experienced clinicians may have difficulties diagnosing GABHS pharyngitis solely based on epidemiologic or clinical grounds alone. Patients suspected of having GABHS pharyngitis should be confirmed by microbiologic testing (e.g., culture, rapid antigen detection test, molecular point-of-care test) of a throat swab specimen prior to the initiation of antimicrobial therapy. Microbiologic testing is generally unnecessary in patients with pharyngitis whose clinical and epidemiologic findings do not suggest GABHS. Clinical score systems such as the Centor score and McIssac score have been developed to help clinicians decide which patients should undergo diagnostic testing and reduce the unnecessary use of antimicrobials. Antimicrobial therapy should be initiated without delay once the diagnosis is confirmed. Oral penicillin V and amoxicillin remain the drugs of choice. For patients who have a non-anaphylactic allergy to penicillin, oral cephalosporin is an acceptable alternative. For patients with a history of immediate, anaphylactic-type hypersensitivity to penicillin, oral clindamycin, clarithromycin, and azithromycin are acceptable alternatives.
Conclusion: Early diagnosis and antimicrobial treatment are recommended to prevent suppurative complications (e.g., cervical lymphadenitis, peritonsillar abscess) and non-suppurative complications (particularly rheumatic fever) as well as to reduce the severity of symptoms, to shorten the duration of the illness and to reduce disease transmission.
Keywords: Centor score, group A ß-hemolytic Streptococcus, McIssac score, pharyngitis, strawberry tongue, Streptococcus pyogenes.
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Graphical Abstract

[1]
Ashurst JV, Edgerley-Gibb L. Streptococcal pharyngitis. Treasure Island, FL: StatPearls Publishing 2022.

[2]
Miller KM, Tanz RR, Shulman ST, et al. Standardization of epidemiological surveillance of group a streptococcal pharyngitis. Open Forum Infect Dis  2022; 9(1): S5-S14.
 [http://dx.doi.org/10.1093/ofid/ofac251 ] [PMID:  36128410]

[3]
Leung AKC, Kellner JD. Group A β-hemolytic streptococcal pharyngitis in children. Adv Ther  2004; 21(5): 277-87.
 [http://dx.doi.org/10.1007/BF02850032 ] [PMID:  15727397]

[4]
American Academy of Pediatrics. Group A streptococcal infectiond.Red Book: 2021-2024 Report of the Committee on Infectious Diseases 32nd ed.  Kimberlin DW, Barnett ED, Lynfield R, Swayer MH, Eds. Itasca, IL: American Academy of Pediatrics 2021; pp. 694-707.

[5]
Bisno AL, Gerber MA, Gwaltney JM Jr, Kaplan EL, Schwartz RH. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Clin Infect Dis  2002; 35(2): 113-25.
 [http://dx.doi.org/10.1086/340949 ] [PMID:  12087516]

[6]
Chiappini E, Regoli M, Bonsignori F, et al. Analysis of different recommendations from international guidelines for the management of acute pharyngitis in adults and children. Clin Ther  2011; 33(1): 48-58.
 [http://dx.doi.org/10.1016/j.clinthera.2011.02.001 ] [PMID:  21397773]

[7]
Gerber MA, Baltimore RS, Eaton CB, et al. Prevention of rheumatic fever and diagnosis and treatment of acute streptococcal pharyngitis. Circulation  2009; 119(11): 1541-51.
 [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.191959 ] [PMID:  19246689]

[8]
Pelucchi C, Grigoryan L, Galeone C. Guideline for the management of acute sore throat: ESCMID sore throat guideline group. Clin Microbiol Infect  2012; 18(1): 1-28.
 [http://dx.doi.org/10.1111/j.1469-0691.2012.03766.x]

[9]
Randel A. IDSA updates guideline for managing group A streptococcal pharyngitis. Am Fam Physician  2013; 88(5): 338-40.
 [PMID:  24010402]

[10]
Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the infectious diseases society of america. Clin Infect Dis  2012; 55(10): e86-e102.
 [http://dx.doi.org/10.1093/cid/cis629 ] [PMID:  22965026]

[11]
Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the infectious diseases society of america. Clin Infect Dis  2012; 55(10): 1279-82.
 [http://dx.doi.org/10.1093/cid/cis847 ] [PMID:  23091044]

[12]
Snow V, Mottur-Pilson C, Cooper RJ, Hoffman JR. Principles of appropriate antibiotic use for acute pharyngitis in adults. Ann Intern Med  2001; 134(6): 506-8.
 [http://dx.doi.org/10.7326/0003-4819-134-6-200103200-00018 ] [PMID:  11255529]

[13]
Mazur E. Management of acute streptococcal pharyngitis: Still the subject of controversy. Open Med  2013; 8(6): 713-9.
 [http://dx.doi.org/10.2478/s11536-013-0216-z ] [PMID:  32215121]

[14]
Di Muzio I, d’Angelo DM, Di Battista C, et al. Pediatrician’s approach to diagnosis and management of group A streptococcal pharyngitis. Eur J Clin Microbiol Infect Dis  2020; 39(6): 1103-7.
 [http://dx.doi.org/10.1007/s10096-020-03821-y ] [PMID:  31984431]

[15]
Luo R, Sickler J, Vahidnia F, Lee YC, Frogner B, Thompson M. Diagnosis and management of group a streptococcal pharyngitis in the United States, 2011-2015. BMC Infect Dis  2019; 19(1): 193.
 [http://dx.doi.org/10.1186/s12879-019-3835-4 ] [PMID:  30808305]

[16]
Sarrell EM, Giveon SM. Streptococcal pharyngitis: A prospective study of compliance and complications. ISRN Pediatr  2012; 2012: 1-8.
 [http://dx.doi.org/10.5402/2012/796389 ] [PMID:  22778988]

[17]
Thompson JM, Zagel AL, Spaulding AB, Krause EA, Arms JL. Streptococcal pharyngitis. Pediatr Emerg Care  2022; 38(2): e519-23.
 [http://dx.doi.org/10.1097/PEC.0000000000002512] [PMID:  34417790]

[18]
Tran J, Danchin M, Pirotta M, Steer AC. Management of sore throat in primary care. Aust J Gen Pract  2018; 47(7): 485-9.
 [http://dx.doi.org/10.31128/AJGP-11-17-4393 ] [PMID:  30114874]

[19]
Leung TNH, Hon KL, Leung AKC, Group A. Streptococcus disease in Hong Kong children: An overview. Hong Kong Med J  2018; 24(6): 593-601.
 [http://dx.doi.org/10.12809/hkmj187275 ] [PMID:  30416105]

[20]
Leung AKC. Group A β-hemolytic streptococcal pharyngitis. Common Problems in Ambulatory Pediatrics: Specific Clinical Problems.  New York: Nova Science Publishers, Inc 2011; 1: pp. 247-55.

[21]
Newberger R, Gupta V. Streptococcus group A. Treasure Island, FL: StatPearls Publishing 2022.
 [PMID:  3264466]

[22]
Shulman ST, Tanz RR. Group A streptococcal pharyngitis and immune-mediated complications: From diagnosis to management. Expert Rev Anti Infect Ther  2010; 8(2): 137-50.
 [http://dx.doi.org/10.1586/eri.09.134 ] [PMID:  20109044]

[23]
Norton L, Myers A. The treatment of streptococcal tonsillitis/pharyngitis in young children. World J Otorhinolaryngol Head Neck Surg  2021; 7(3): 161-5.
 [http://dx.doi.org/10.1016/j.wjorl.2021.05.005 ] [PMID:  34430823]

[24]
Stollerman GH, Dale JB. The importance of the group a streptococcus capsule in the pathogenesis of human infections: A historical perspective. Clin Infect Dis  2008; 46(7): 1038-45.
 [http://dx.doi.org/10.1086/529194 ] [PMID:  18444821]

[25]
Tanz RR, Gewitz MH, Kaplan EL, Shulman ST. Stay the course: Targeted evaluation, accurate diagnosis, and treatment of streptococcal pharyngitis prevent acute rheumatic fever. J Pediatr  2020; 216: 208-12.
 [http://dx.doi.org/10.1016/j.jpeds.2019.08.042 ] [PMID:  31561955]

[26]
Alcaide ML, Bisno AL. Pharyngitis and epiglottitis. Infect Dis Clin North Am  2007; 21(2): 449-69.
 [http://dx.doi.org/10.1016/j.idc.2007.03.001]

[27]
Jaggi P, Shulman ST. Group A streptococcal infections. Pediatr Rev  2006; 27(3): 99-105.
 [http://dx.doi.org/10.1542/pir.27.3.99 ] [PMID:  16510550]

[28]
Shaikh N, Leonard E, Martin JM. Prevalence of streptococcal pharyngitis and streptococcal carriage in children: A meta-analysis. Pediatrics  2010; 126(3): e557-64.
 [http://dx.doi.org/10.1542/peds.2009-2648 ] [PMID:  20696723]

[29]
Ahluwalia T, Jain S, Norton L, Meade J, Etherton-Still J, Myers A. Reducing streptococcal testing in patients <3 years old in an emergency department. Pediatrics  2019; 144(4): e20190174.
 [http://dx.doi.org/10.1542/peds.2019-0174 ] [PMID:  31511313]

[30]
Sauve L, Forrester AM, Top KA. Group A streptococcal pharyngitis: A practical guide to diagnosis and treatment. Paediatr Child Health  2021; 26(5): 319-20.
 [http://dx.doi.org/10.1093/pch/pxab025 ] [PMID:  34336062]

[31]
Wi D, Choi SH. Positive rate of tests for group A streptococcus and viral features in children with acute pharyngitis. Children  2021; 8(7): 599.
 [http://dx.doi.org/10.3390/children8070599 ] [PMID:  34356578]

[32]
Sharif MR, Aalinezhad M, Sajadian SMS, Haji Rezaei M. Streptococcal pharyngitis in a two-month-old infant: A case report. Jundishapur J Microbiol  2016; 9(5): e32630.
 [http://dx.doi.org/10.5812/jjm.32630 ] [PMID:  27540457]

[33]
Borchardt RA. Diagnosis and management of group A beta-hemolytic streptococcal pharyngitis. JAAPA  2013; 26(9): 53-4.
 [http://dx.doi.org/10.1097/01.JAA.0000433876.39648.52] [PMID: 24069674]

[34]
Kronman MP, Zhou C, Mangione-Smith R. Bacterial prevalence and antimicrobial prescribing trends for acute respiratory tract infections. Pediatrics  2014; 134(4): e956-65.
 [http://dx.doi.org/10.1542/peds.2014-0605 ] [PMID:  25225144]

[35]
Mustafa Z, Ghaffari M. Diagnostic methods, clinical guidelines, and antibiotic treatment for group A streptococcal pharyngitis: A narrative review. Front Cell Infect Microbiol  2020; 10: 563627.
 [http://dx.doi.org/10.3389/fcimb.2020.563627 ] [PMID:  33178623]

[36]
Kennis M, Tagawa A, Kung VM, et al. Seasonal variations and risk factors of Streptococcus pyogenes infection: A multicenter research network study. Ther Adv Infect Dis  2022; 9
 [http://dx.doi.org/10.1177/20499361221132101] [PMID:  36277299]

[37]
Wald ER. Group A streptococcal tonsillopharyngitis in children and adolescents: Clinical features and diagnosis.UpToDate. 

[38]
Langlois DM, Andreae M. Group A streptococcal infections. Pediatr Rev  2011; 32(10): 423-30.
 [http://dx.doi.org/10.1542/pir.32.10.423 ] [PMID:  21965709]

[39]
Takayama Y, Hikawa S, Okada J, Sunakawa K, Akahoshi T. A foodborne outbreak of a group A streptococcal infection in a Japanese university hospital. Eur J Clin Microbiol Infect Dis  2009; 28(3): 305-8.
 [http://dx.doi.org/10.1007/s10096-008-0614-3 ] [PMID:  18716803]

[40]
Bennett J, Moreland NJ, Zhang J, et al. Risk factors for group A streptococcal pharyngitis and skin infections: A case control study. Lancet Regional Health - Western Pacific  2022; 26: 100507.
 [http://dx.doi.org/10.1016/j.lanwpc.2022.100507] [PMID: 35789826]

[41]
Asteberg I, Andersson Y, Dotevall L, et al. A food-borne streptococcal sore throat outbreak in a small community. Scand J Infect Dis  2006; 38(11-12): 988-94.
 [http://dx.doi.org/10.1080/00365540600868370 ] [PMID:  17148066]

[42]
Culqui DR, Manzanares-Laya S, Van Der Sluis SL, et al. Group A β-hemolytic streptococcal pharyngotonsillitis outbreak. Rev Saude Publica  2014; 48(2): 322-5.
 [http://dx.doi.org/10.1590/S0034-8910.2014048005091] [PMID:  24897054]

[43]
Kemble SK, Westbrook A, Lynfield R, et al. Foodborne outbreak of group a streptococcus pharyngitis associated with a high school dance team banquet-Minnesota, 2012. Clin Infect Dis  2013; 57(5): 648-54.
 [http://dx.doi.org/10.1093/cid/cit359 ] [PMID:  23868521]

[44]
Wessels MR. Streptococcal Pharyngitis. N Engl J Med  2011; 364(7): 648-55.
 [http://dx.doi.org/10.1056/NEJMcp1009126 ] [PMID:  21323542]

[45]
Levin RM, Grossman M, Jordan C, Ticknor W, Barnett P, Pascoe D. Group A streptococcal infection in children younger than three years of age. Pediatr Infect Dis J  1988; 7(8): 581-7.
 [PMID:  3050854]

[46]
Anjos LMM, Marcondes MB, Lima MF, Mondelli AL, Okoshi MP. Streptococcal acute pharyngitis. Rev Soc Bras Med Trop  2014; 47(4): 409-13.
 [http://dx.doi.org/10.1590/0037-8682-0265-2013 ] [PMID:  25229278]

[47]
Ebell MH. Diagnosis of streptococcal pharyngitis. Am Fam Physician  2014; 89(12): 976-7.
 [PMID:  25162166]

[48]
Li LYJ, Wang SY, Tsai CY, Wu CJ. Group A streptococcal pharyngitis. BMJ Case Rep  2021; 14(9): e244871.
 [http://dx.doi.org/10.1136/bcr-2021-244871 ] [PMID:  34593551]

[49]
Nasirian H. TarvijEslami S, Matini E, Bayesh S, Omaraee Y. A clinical decision rule for streptococcal pharyngitis management: An update. J Lab Physicians  2017; 9(2): 116-20.
 [http://dx.doi.org/10.4103/0974-2727.199635 ] [PMID:  28367027]

[50]
Sahu M, Sahoo PR. Strawberry tongue in streptococcal pharyngitis. N Engl J Med  2021; 384(12): 1144.
 [http://dx.doi.org/10.1056/NEJMicm2026930 ] [PMID:  33761210]

[51]
Inamadar AC, Adya KA, Palit A. The strawberry tongue: What, how and where? Indian J Dermatol Venereol Leprol  2018; 84(4): 500-5.
 [http://dx.doi.org/10.4103/ijdvl.IJDVL_57_17 ] [PMID:  29620043]

[52]
Pardo S, Perera TB. Scarlet fever. Treasure Island, FL: StatPearls Publishing 2022.

[53]
Sil A, Chakraborty S, Bhanja DB, Mondal S, Panigrahi A. Doughnut lesions over palate in streptococcal pharyngitis. Indian J Pediatr  2020; 87(7): 573.
 [http://dx.doi.org/10.1007/s12098-020-03242-x ] [PMID:  32088912]

[54]
Jo SA, Ma SH, Kim S. Diagnostic impact of clinical manifestations of group A streptococcal pharyngitis. Infect Chemother  2021; 53(3): 553-6.
 [http://dx.doi.org/10.3947/ic.2021.0042 ] [PMID:  34623782]

[55]
Sykes EA, Wu V, Beyea MM, Simpson MTW, Beyea JA. Pharyngitis: Approach to diagnosis and treatment. Can Fam Physician  2020; 66(4): 251-7.
 [PMID:  32273409]

[56]
Pankhurst CL. Candidiasis (oropharyngeal). Clin Evid  2013; 2013: 1304.
 [PMID:  24209593]

[57]
Gottlieb M, Long B, Koyfman A. Clinical mimics: An emergency medicine-focused review of streptococcal pharyngitis mimics. J Emerg Med  2018; 54(5): 619-29.
 [http://dx.doi.org/10.1016/j.jemermed.2018.01.031] [PMID:  29523424]

[58]
Leung AKC, Rafaat M. Eruption associated with amoxicillin in a patient with infectious mononucleosis. Int J Dermatol  2003; 42(7): 553-5.
 [http://dx.doi.org/10.1046/j.1365-4362.2003.01699_1.x] [PMID:  12839608]

[59]
Leung AKC, Wong AH, Leong KF. Infectious mononucleosis: Clinical manifestations, investigations, and management. Advances in Health and Disease.  New York: Nova Science Publishers, Inc 2018; 6: pp. 45-71.

[60]
Leung AK, Cho H. Diagnosis of stridor in children. Am Fam Physician  1999; 60(8): 2289-96.
 [PMID:  10593320]

[61]
Fleisher GR, Fine AM. Evaluation of sore throat in children. UpToDate. 

[62]
Lamichhane A, Radhakrishnan S.  In: StatPearls. Treasure Island, FL: StatPearls Publishing 2022.

[63]
Leung AKC, Sergi CM, Leong KF, Kantor PF, Md Md. Visual diagnosis: High fever, maculopapular rash, perianal desquamation, and conjunctivitis in a 3-year-old boy. Pediatr Rev  2021; 42(5): e17-22.
 [http://dx.doi.org/10.1542/pir.2018-0330 ] [PMID:  33931516]

[64]
Loo SK, Hon KL, Leung AKC, Yung TC, Yam MC. Kawasaki disease in siblings and a review of drug treatment. Drugs Context  2020; 9: 1-5.
 [http://dx.doi.org/10.7573/dic.2020-4-1 ] [PMID:  32699547]

[65]
Yu H, Li XW, Liu QB, et al. Diagnosis and treatment of herpangina: Chinese expert consensus. World J Pediatr  2020; 16(2): 129-34.
 [http://dx.doi.org/10.1007/s12519-019-00277-9 ] [PMID:  31347021]

[66]
Hon KL, Leung AKC, Leung K, Chan GCF. Measles outbreak at an international airport: A Hong Kong perspective. Hong Kong Med J  2019; 25(4): 331-3.
 [http://dx.doi.org/10.12809/hkmj197962 ] [PMID:  31416996]

[67]
Leung AKC, Hon KL, Leong KF, Sergi CM. Measles: A disease often forgotten but not gone. Hong Kong Med J  2018; 24(5): 512-20.
 [http://dx.doi.org/10.12809/hkmj187470 ] [PMID:  30245481]

[68]
Hoy NY, Leung AKC, Metelitsa AI, Adams S. New concepts in median nail dystrophy, onychomycosis, and hand, foot, and mouth disease nail pathology. ISRN Dermatol  2012; 2012: 1-5.
 [http://dx.doi.org/10.5402/2012/680163 ] [PMID:  22462009]

[69]
Leung AKC, Lam JM, Barankin B, Leong KF, Hon KL. Hand, foot, and mouth disease: A narrative review. Recent Adv Inflamm Allergy Drug Discov  2022; 16(2): 77-95.
 [http://dx.doi.org/10.2174/1570180820666221024095837]

[70]
Leung AKC, Kao CP, Sauve RS. Scarring resulting from chickenpox. Pediatr Dermatol  2001; 18(5): 378-80.
 [http://dx.doi.org/10.1046/j.1525-1470.2001.01975.x] [PMID:  11737678]

[71]
Adil A, Goyal A, Quint JM. Behcet disease. Treasure Island, FL: StatPearls Publishing 2022.

[72]
Khemiss M, Hajjaj S, Blouza I, Beji M. Oral manifestations of Behçet’s disease. Tunis Med  2022; 100(4): 303-8.
 [PMID:  36155901]

[73]
Ohnishi T, Sato S, Uejima Y, Kawano Y, Suganuma E. Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome: Clinical characteristics and treatment outcomes - a single center study in Japan. Pediatr Int  2022; 64(1): e15294.
 [http://dx.doi.org/10.1111/ped.15294 ] [PMID:  36134651]

[74]
Shaikh N, Swaminathan N, Hooper EG. Accuracy and precision of the signs and symptoms of streptococcal pharyngitis in children: A systematic review. J Pediatr  2012; 160(3): 487-493.e3.
 [http://dx.doi.org/10.1016/j.jpeds.2011.09.011 ] [PMID:  22048053]

[75]
Shah R, Bansal A, Singhi SC. Approach to a child with sore throat. Indian J Pediatr  2011; 78(10): 1268-72.
 [http://dx.doi.org/10.1007/s12098-011-0467-0 ] [PMID:  21660400]

[76]
Bird C, Winzor G, Lemon K, Moffat A, Newton T, Gray J. A pragmatic study to evaluate the use of a rapid diagnostic test to detect group A streptococcal pharyngitis in children with the aim of reducing antibiotic use in a UK emergency department. Pediatr Emerg Care Publish Ahead of Print  2018; 5: e249-251.
 [http://dx.doi.org/10.1097/PEC.0000000000001560] [PMID: 30045356]

[77]
Centor RM, Witherspoon JM, Dalton HP, Brody CE, Link K. The diagnosis of strep throat in adults in the emergency room. Med Decis Making  1981; 1(3): 239-46.
 [http://dx.doi.org/10.1177/0272989X8100100304 ] [PMID:  6763125]

[78]
McIsaac WJ, White D, Tannenbaum D, Low DE. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ  1998; 158(1): 75-83.
 [PMID:  9475915]

[79]
Nawaz H, Smith DS, Mazhari R, Katz DL. Concordance of clinical findings and clinical judgment in the diagnosis of streptococcal pharyngitis. Acad Emerg Med  2000; 7(10): 1104-9.
 [http://dx.doi.org/10.1111/j.1553-2712.2000.tb01259.x] [PMID:  11015241]

[80]
Science M, Bitnun A, McIsaac W. Identifying and treating group A streptococcal pharyngitis in children. CMAJ  2015; 187(1): 13.
 [http://dx.doi.org/10.1503/cmaj.141532 ] [PMID:  25512654]

[81]
Bo ZM, Tan WK, Chong CSC, et al. Respiratory microorganisms in acute pharyngitis patients: Identification, antibiotic prescription patterns and appropriateness, and antibiotic resistance in private primary care, central Malaysia. PLoS One  2022; 17(11): e0277802.
 [http://dx.doi.org/10.1371/journal.pone.0277802 ] [PMID:  36395327]

[82]
Le Marechal F, Martinot A, Duhamel A, Pruvost I, Dubos F. Streptococcal pharyngitis in children: A meta-analysis of clinical decision rules and their clinical variables. BMJ Open  2013; 3(3): e001482.
 [http://dx.doi.org/10.1136/bmjopen-2012-001482 ] [PMID:  23474784]

[83]
Muthanna A, Shamsuddin NH, Abdul Rashid A, et al. Diagnostic accuracy of Centor score for diagnosis of group A streptococcal pharyngitis among adults in primary care clinics in Malaysia. Malays J Med Sci  2022; 29(4): 88-97.
 [http://dx.doi.org/10.21315/mjms2022.29.4.9 ] [PMID:  36101529]

[84]
Bayless S, Bihl T, Rohan CA, Travers JB, Whitney E. Inappropriate testing of streptococcal pharyngitis in children aged below 3 years: Application of statistical process control. Clin Pediatr (Phila)  2022; 99228221125823
 [http://dx.doi.org/10.1177/00099228221125823] [PMID:  36171730]

[85]
de Moraes-Pinto MI. Streptococcal pharyngotonsillitis: Need of microbiological tests in order to have a precise diagnosis. Rev Paul Pediatr  2013; 31(1): 2-3.
 [http://dx.doi.org/10.1590/S0103-05822013000100001] [PMID:  23703036]

[86]
Shapiro DJ, Lindgren CE, Neuman MI, Fine AM. Viral features and testing for streptococcal pharyngitis. Pediatrics  2017; 139(5): e20163403.
 [http://dx.doi.org/10.1542/peds.2016-3403 ] [PMID:  28557742]

[87]
Kaplan EL, Gastanaduy AS, Huwe BB. The role of the carrier in treatment failures after antibiotic for group A streptococci in the upper respiratory tract. J Lab Clin Med  1981; 98(3): 326-35.
 [PMID:  7021717]

[88]
 Pichichero ME. Treatment and prevention of streptococcal tonsillopharyngitis in adults and children. In: Post, TW, ed. UpToDate. Waltham, MA. (Accessed on December 1, 2022).

[89]
Choby BA. Diagnosis and treatment of streptococcal pharyngitis. Am Fam Physician  2009; 79(5): 383-90.
 [PMID:  19275067]

[90]
Azrad M, Danilov E, Goshen S, Nitzan O, Peretz A. Detection of group a Streptococcus in pharyngitis by two rapid tests: Comparison of the BD Veritor™ and the QuikRead go® Strep A. Eur J Clin Microbiol Infect Dis  2019; 38(6): 1179-85.
 [http://dx.doi.org/10.1007/s10096-019-03527-w ] [PMID:  30852698]

[91]
Leung AKC, Newman R, Kumar A, Davies HD. Rapid antigen detection testing in diagnosing group A β-hemolytic streptococcal pharyngitis. Expert Rev Mol Diagn  2006; 6(5): 761-6.
 [http://dx.doi.org/10.1586/14737159.6.5.761 ] [PMID:  17009909]

[92]
Hendi SB, Malik ZA, Khamis AH, Al-Najjar FYA. High diagnostic accuracy of automated rapid Strep A test reduces antibiotic prescriptions for children in the United Arab Emirates. BMC Pediatr  2021; 21(1): 52.
 [http://dx.doi.org/10.1186/s12887-021-02516-3 ] [PMID:  33494718]

[93]
Cohen JF, Bertille N, Cohen R, Chalumeau M. Rapid antigen detection test for group A streptococcus in children with pharyngitis. Cochrane Libr  2016; 2016(7): CD010502.
 [http://dx.doi.org/10.1002/14651858.CD010502.pub2] [PMID:  27374000]

[94]
Küçük Ö, Biçer S, Giray T, et al. Validity of rapid antigen detection testing in group A beta-hemolytic streptococcal tonsillopharyngitis. Indian J Pediatr  2014; 81(2): 138-42.
 [http://dx.doi.org/10.1007/s12098-013-1067-y ] [PMID:  23749414]

[95]
Ehrlich JE, Demopoulos BP, Daniel KR Jr, Ricarte MC, Glied S. Cost-effectiveness of treatment options for prevention of rheumatic heart disease from Group A streptococcal pharyngitis in a pediatric population. Prev Med  2002; 35(3): 250-7.
 [http://dx.doi.org/10.1006/pmed.2002.1062 ] [PMID:  12202067]

[96]
Lean WL, Arnup S, Danchin M, Steer AC. Rapid diagnostic tests for group A streptococcal pharyngitis: A meta-analysis. Pediatrics  2014; 134(4): 771-81.
 [http://dx.doi.org/10.1542/peds.2014-1094 ] [PMID:  25201792]

[97]
Bilir SP, Kruger E, Faller M, et al. US cost-effectiveness and budget impact of point-of-care NAAT for streptococcus. Am J Manag Care  2021; 27(5): e157-63.
 [http://dx.doi.org/10.37765/ajmc.2021.88638 ] [PMID:  34002967]

[98]
Dubois C, Smeesters PR, Refes Y, et al. Diagnostic accuracy of rapid nucleic acid tests for group A streptococcal pharyngitis: Systematic review and meta-analysis. Clin Microbiol Infect  2021; 27(12): 1736-45.
 [http://dx.doi.org/10.1016/j.cmi.2021.04.021 ] [PMID:  33964409]

[99]
Toptan H, Agel E, Sagcan H, et al. Rapid molecular diagnosis of group A streptococcus with a novel loop mediated isothermal amplification method. Clin Lab  2022; 68((08/2022))
 [http://dx.doi.org/10.7754/Clin.Lab.2021.210925] [PMID: 35975490]

[100]
Dunne EM, Marshall JL, Baker CA, et al. Detection of group a streptococcal pharyngitis by quantitative PCR. BMC Infect Dis  2013; 13(1): 312.
 [http://dx.doi.org/10.1186/1471-2334-13-312 ] [PMID:  23844865]

[101]
Felsenstein S, Faddoul D, Sposto R, Batoon K, Polanco CM, Dien Bard J. Molecular and clinical diagnosis of group A streptococcal pharyngitis in children. J Clin Microbiol  2014; 52(11): 3884-9.
 [http://dx.doi.org/10.1128/JCM.01489-14 ] [PMID:  25143573]

[102]
Ganti L, Long BJ. What is the diagnostic accuracy of rapid nucleic acid tests for group A streptococcal pharyngitis? Ann Emerg Med  2022; 79(4): 388-90.
 [http://dx.doi.org/10.1016/j.annemergmed.2021.09.421] [PMID:  34756451]

[103]
Graf EH. Can rapid molecular Streptococcus pyogenes testing lead to better antimicrobial stewardship for acute pharyngitis? J Appl Lab Med  2019; 4(2): 140-2.
 [http://dx.doi.org/10.1373/jalm.2019.029983 ] [PMID:  31639658]

[104]
Jaggi P, Leber A. Molecular testing for group A streptococcal pharyngitis: To test or not to test, that is the question. J Pediatric Infect Dis Soc 2018.
 [http://dx.doi.org/10.1093/jpids/pix106 ] [PMID:  29718291]

[105]
Rao A, Berg B, Quezada T, et al. Diagnosis and antibiotic treatment of group a streptococcal pharyngitis in children in a primary care setting: Impact of point-of-care polymerase chain reaction. BMC Pediatr  2019; 19(1): 24.
 [http://dx.doi.org/10.1186/s12887-019-1393-y ] [PMID:  30651115]

[106]
Robinson JL. Paediatrics: How to manage pharyngitis in an era of increasing antimicrobial resistance. Drugs Context  2020; 2021(10)
 [http://dx.doi.org/10.7573/dic.2020-11-6] [PMID:  33828608]

[107]
Shapiro DJ, Fine AM, Hersh AL, Bourgeois FT. Association between molecular streptococcal testing and antibiotic use for pharyngitis in children. J Pediatric Infect Dis Soc  2022; 11(6): 303-4.
 [http://dx.doi.org/10.1093/jpids/piac008 ] [PMID:  35253892]

[108]
Tanz RR, Heaberlin LE, Harvey E. Performance of a molecular test for group A streptococcus pharyngitis. J Pediatric Infect Dis Soc  2023; 12(1): 56-9.
 [http://dx.doi.org/10.1093/jpids/piac115 ] [PMID:  36322677]

[109]
Taylor A, Morpeth S, Webb R, Taylor S. The utility of rapid group A streptococcus molecular testing compared with throat culture for the diagnosis of group A streptococcal pharyngitis in a high-incidence rheumatic fever population. J Clin Microbiol  2021; 59(12): e00978-21.
 [http://dx.doi.org/10.1128/JCM.00978-21 ] [PMID:  34550808]

[110]
Pritt BS, Patel R, Kirn TJ, Thomson RB Jr. Point-counterpoint: A nucleic acid amplification test for streptococcus pyogenes should replace antigen detection and culture for detection of bacterial pharyngitis. J Clin Microbiol  2016; 54(10): 2413-9.
 [http://dx.doi.org/10.1128/JCM.01472-16 ] [PMID:  27440817]

[111]
Ruppert SD, Fay VP. Pharyngitis. Nurse Pract  2015; 40(7): 18-25.
 [http://dx.doi.org/10.1097/01.NPR.0000466498.57296.60 ] [PMID:  26080293]

[112]
Stuempfig ND, Seroy J. Monospot test. Treasure Island, FL: StatPearls Publishing 2021.

[113]
Wang EX, Kussman A, Hwang CE. Use of Monospot testing in the diagnosis of infectious mononucleosis in the collegiate student-athlete population. Clin J Sport Med  2022; 32(5): 467-70.
 [http://dx.doi.org/10.1097/JSM.0000000000000996] [PMID:  36083325]

[114]
Christensen AMG, Thomsen MK, Ovesen T, Klug TE. Are procalcitonin or other infection markers useful in the detection of group A streptococcal acute tonsillitis? Scand J Infect Dis  2014; 46(5): 376-83.
 [http://dx.doi.org/10.3109/00365548.2014.885656 ] [PMID:  24606046]

[115]
Yu J, Tycksen E, Yang W, et al. Use of host response to refine the diagnosis of group A streptococcal pharyngitis. J Pediatric Infect Dis Soc  2022; 11(11): 482-91.
 [http://dx.doi.org/10.1093/jpids/piac072 ] [PMID:  36153766]

[116]
Bella Z, Erdelyi E, Szalenko-Tőkés Á, et al. Peritonsillar abscess: An 8-year retrospective, culture based evaluation of 208 cases. J Med Microbiol  2022; 71(9)
 [http://dx.doi.org/10.1099/jmm.0.001576] [PMID:  36107755]

[117]
Alexandre M, Wang’ondu R, Cooney LM Jr. Group A streptococcal bacteremia following streptococcal pharyngitis in an older patient with diabetes: A case report. Yale J Biol Med  2017; 90(2): 337-40.
 [PMID:  28656020]

[118]
Zink JU, Morse BC, Vercruysse GA, Dente CJ, Jones YR, Feliciano DV. Remote group A β-hemolytic Streptococcal fasciitis and myositis: A rare complication from hematogenous spread of Streptococcal pharyngitis. Am Surg  2013; 79(9): 296-7.
 [http://dx.doi.org/10.1177/000313481307900905 ] [PMID:  24069966]

[119]
Taniguchi H, Aimi M, Matsushita H, Shimazaki G. A case of phlegmonous gastritis after acute pharyngitis. Clin J Gastroenterol  2021; 14(2): 500-5.
 [http://dx.doi.org/10.1007/s12328-021-01345-2 ] [PMID:  33539005]

[120]
Sharp EA, Linn A, Zitelli BJ. Group A streptococcal pharyngitis associated with primary peritonitis. BMJ Case Rep  2019; 12(5): e229186.
 [http://dx.doi.org/10.1136/bcr-2019-229186 ] [PMID:  31061197]

[121]
Sheikh S, Javed U, Baig MA. Streptococcal pharyngitis: Delving deeper than the throat. J Coll Physicians Surg Pak  2021; 31(6): 732-4.
 [http://dx.doi.org/10.29271/jcpsp.2021.06.732 ] [PMID:  34102792]

[122]
Shah RK, Wofford MM, West TG, Shetty AK. Lemierre syndrome associated with group A streptococcal infection. Am J Emerg Med  2010; 28(5): 643.e5-8.
 [http://dx.doi.org/10.1016/j.ajem.2009.09.011 ] [PMID:  20579574]

[123]
Pichichero ME. Complications of streptococcal tonsillopharyngitis. UpToDate. 

[124]
Walden JH, Hess B, Rigby M. Streptococcal pharyngitis: An uncommon cause of subdural empyema. BMJ Case Rep  2015; 2015: bcr2015211312.
 [http://dx.doi.org/10.1136/bcr-2015-211312 ] [PMID:  26385939]

[125]
Scheel A, Beaton AZ, Katzenellenbogen J, et al. Standardization of epidemiological surveillance of acute rheumatic fever. Open Forum Infect Dis  2022; 9 (Suppl. 1): S41-9.
 [http://dx.doi.org/10.1093/ofid/ofac252 ] [PMID:  36128408]

[126]
Kulik E, Stuart B, Willcox M. Predictors of rheumatic fever in sore throat patients: A systematic review and meta-analysis. Trans R Soc Trop Med Hyg  2022; 116(4): 286-97.
 [http://dx.doi.org/10.1093/trstmh/trab156 ] [PMID:  34636404]

[127]
Noguchi K, Arain N, Galloway C. Acute rheumatic fever: Case report and literature review. S D Med  2022; 75(5): 212-5.
 [PMID:  35724350]

[128]
Sato S, Uejima Y, Suganuma E, Takano T, Kawano Y. A retrospective study: Acute rheumatic fever and post-streptococcal reactive arthritis in Japan. Allergol Int  2017; 66(4): 617-20.
 [http://dx.doi.org/10.1016/j.alit.2017.04.001 ] [PMID:  28442182]

[129]
Schmutzler L, Mirna M, Hoppe UC, Lichtenauer M. From streptococcal pharyngitis/tonsillitis to myocarditis: A systematic review. J Cardiovasc Dev Dis  2022; 9(6): 170.
 [http://dx.doi.org/10.3390/jcdd9060170 ] [PMID:  35735799]

[130]
Dooley LM, Ahmad TB, Pandey M, Good MF, Kotiw M. Rheumatic heart disease: A review of the current status of global research activity. Autoimmun Rev  2021; 20(2): 102740.
 [http://dx.doi.org/10.1016/j.autrev.2020.102740 ] [PMID:  33333234]

[131]
Pancholia AK, Vijaylakshmi IB, Mohan Rao PS, et al. Rheumatic heart disease in India in 2020: Advances in diagnostic and therapeutic options. J Assoc Physicians India  2022; 70(1): 11-2.
 [PMID:  35062813]

[132]
Rwebembera J, Nascimento BR, Minja NW, et al. Recent advances in the rheumatic fever and rheumatic heart disease continuum. Pathogens  2022; 11(2): 179.
 [http://dx.doi.org/10.3390/pathogens11020179 ] [PMID:  35215123]

[133]
Allen J, Munoz C, Byakova A, Pachulski R. Acute fulminant group A beta-hemolytic streptococcus-associated carditis: A case report and literature review. Cureus  2022; 14(7): e27282.
 [http://dx.doi.org/10.7759/cureus.27282 ] [PMID:  36039237]

[134]
Boruah P, Shetty S, Kumar SS. Acute streptococcal myocarditis presenting as acute ST-elevation myocardial infarction. J Invasive Cardiol  2010; 22(10): E189-91.
 [PMID:  20944196]

[135]
Chaudhuri A, Dooris M, Woods ML. Non-rheumatic streptococcal myocarditis – warm hands, warm heart. J Med Microbiol  2013; 62(1): 169-72.
 [http://dx.doi.org/10.1099/jmm.0.049569-0 ] [PMID:  23002069]

[136]
Hiraiwa H, Morimoto R, Ando R, et al. Recurrent fulminant non-rheumatic streptococcal myocarditis proven by endomyocardial biopsy and autopsy. J Cardiol Cases  2022; 26(1): 62-5.
 [http://dx.doi.org/10.1016/j.jccase.2022.02.004 ] [PMID:  35923528]

[137]
Kalpakos T, Wilgenhof A, Michiels V, Cosyns B, Vermeersch P. Streptococcal pharyngitis associated myocarditis (SPAM): The perfect ST-segment elevation myocardial infarction (STEMI) mimic in young individuals. A case series. Acta Cardiol  2021; 76(5): 449-54.
 [http://dx.doi.org/10.1080/00015385.2020.1854985] [PMID:  33283669]

[138]
Mavrogeni S, Bratis K, Kitsiou A, Kolovou G. Streptococcal tonsillitis and acute streptococcal myocarditis: An unusual combination assessed by cardiac magnetic resonance imaging and endomyocardial biopsy. Ann Otol Rhinol Laryngol  2012; 121(9): 604-8.
 [http://dx.doi.org/10.1177/000348941212100907 ] [PMID:  23012899]

[139]
Mokabberi R, Shirani J. M AH, Go BD, Schiavone W. Streptococcal pharyngitis-associated myocarditis mimicking acute STEMI. JACC Cardiovasc Imaging  2010; 3(8): 892-3.
 [http://dx.doi.org/10.1016/j.jcmg.2010.05.012 ] [PMID:  20705272]

[140]
Limm-Chan B, Musgrave J, Lau R, Ahn HJ, Nguyen L, Kurahara D. Incidence of acute post-streptococcal glomerulonephritis in Hawai’i and factors affecting length of hospitalization. Hawaii J Health Soc Welf  2020; 79(5): 149-52.
 [PMID:  32432220]

[141]
Martin J, Kaul A, Schacht R. Acute poststreptococcal glomerulonephritis: A manifestation of immune reconstitution inflammatory syndrome. Pediatrics  2012; 130(3): e710-3.
 [http://dx.doi.org/10.1542/peds.2011-1246 ] [PMID:  22891230]

[142]
Ong LT. Management and outcomes of acute post-streptococcal glomerulonephritis in children. World J Nephrol  2022; 11(5): 139-45.
 [http://dx.doi.org/10.5527/wjn.v11.i5.139 ] [PMID:  36187464]

[143]
Robson WL, Leung AK. Post-streptococcal glomerulonephritis with minimal abnormalities in the urinary sediment. J Singapore Paediatr Soc  1992; 34(3-4): 232-4.
 [PMID:  1305669]

[144]
Robson WL, Leung AK. Post-streptococcal glomerulonephritis. Clin Nephrol  1995; 43(2): 139.
 [PMID:  7794396]

[145]
Spernovasilis N, Stylianou K, Milioni A, Panagiotakis S. Microscopic polyangiitis after streptococcal pharyngitis in a young woman. Postgrad Med J  2018; 94(1118): 728.
 [http://dx.doi.org/10.1136/postgradmedj-2018-135674] [PMID:  30282781]

[146]
Medina CA, Fajardo A, Calderon A, Aracena M. Post-streptococcal uveitis: Case report. Ocul Immunol Inflamm  2019; 27(7): 1086-9.
 [http://dx.doi.org/10.1080/09273948.2018.1501493] [PMID:  30081680]

[147]
Millender TW, Reller LB, Meekins LC, Afshari NA. Streptococcal pharyngitis leading to corneal ulceration. Ocul Immunol Inflamm  2012; 20(2): 143-4.
 [http://dx.doi.org/10.3109/09273948.2011.649152 ] [PMID:  22360434]

[148]
Shute CL, Chakravarthy U, McAvoy CE. Unilateral acute idiopathic maculopathy associated with streptococcal pharyngitis, a case report. Ocul Immunol Inflamm  2022; 30(6): 1511-4.
 [http://dx.doi.org/10.1080/09273948.2021.1880603] [PMID:  33793385]

[149]
Murray RC, Chennupati SK. Chronic streptococcal and non-streptococcal pharyngitis. Infect Disord Drug Targets  2012; 12(4): 281-5.
 [http://dx.doi.org/10.2174/187152612801319311 ] [PMID:  22338589]

[150]
Katz BZ. Streptococcal infections and exacerbation in pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection: A systematic review and meta-analysis. Pediatr Infect Dis J  2019; 38(8): e190-1.
 [http://dx.doi.org/10.1097/INF.0000000000002310] [PMID:  31306405]

[151]
Squintani G, Tinazzi M, Gambarin M, et al. Post-streptococcal ‘complex’ movement disorders: Unusual concurrence of psychogenic and organic symptoms. J Neurol Sci  2010; 288(1-2): 68-71.
 [http://dx.doi.org/10.1016/j.jns.2009.10.004 ] [PMID:  19896680]

[152]
Garritsen FM, Kraag DE, de Graaf M. Guttate psoriasis triggered by perianal streptococcal infection. Clin Exp Dermatol  2017; 42(5): 536-8.
 [http://dx.doi.org/10.1111/ced.13129 ] [PMID:  28543851]

[153]
Pfingstler LF, Maroon M, Mowad C. Guttate psoriasis outcomes. Cutis  2016; 97(2): 140-4.
 [PMID:  26919501]

[154]
Saleh D, Tanner LS. Guttate psoriasis. Treasure Island, FL: StatPearls Publishing 2022.

[155]
Hanson V, Khalid SN, Ratmeyer G, Sheikh AB. Thyroid storm secondary to acute Streptococcus pyogenes pharyngitis. Proc Bayl Univ Med Cent  2022; 35(5): 691-2.
 [http://dx.doi.org/10.1080/08998280.2022.2077076] [PMID:  35991738]

[156]
Calado G, Loureiro G, Machado D, et al. Streptococcal tonsillitis as a cause of urticaria. Allergol Immunopathol  2012; 40(6): 341-5.
 [http://dx.doi.org/10.1016/j.aller.2011.06.008 ] [PMID:  21982399]

[157]
Barash J. Group A streptococcal throat infection: To treat or not to treat? Acta Paediatr  2009; 98(3): 434-6.
 [http://dx.doi.org/10.1111/j.1651-2227.2008.01177.x] [PMID:  19133868]

[158]
Leung AKC, Barankin B, Leong KF. Henoch-Schönlein purpura in children: An updated review. Curr Pediatr Rev  2020; 16(4): 265-76.
 [http://dx.doi.org/10.2174/18756336MTA2lNDYc2] [PMID:  32384035]

[159]
Robson WLM, Leung AKC. Acute rheumatic fever and Henoch-Schnlein purpura. Acta Paediatr  2003; 92(4): 513.
 [http://dx.doi.org/10.1111/j.1651-2227.2003.tb00591.x] [PMID:  12801126]

[160]
Cannon JW, Zhung J, Bennett J, et al. The economic and health burdens of diseases caused by group A Streptococcus in New Zealand. Int J Infect Dis  2021; 103: 176-81.
 [http://dx.doi.org/10.1016/j.ijid.2020.11.193 ] [PMID:  33278622]

[161]
Miller KM, Carapetis JR, Van Beneden CA, et al. The global burden of sore throat and group A Streptococcus pharyngitis: A systematic review and meta-analysis. EClinicalMedicine  2022; 48: 101458.
 [http://dx.doi.org/10.1016/j.eclinm.2022.101458 ] [PMID:  35706486]

[162]
Pfoh E, Wessels MR, Goldmann D, Lee GM. Burden and economic cost of group A streptococcal pharyngitis. Pediatrics  2008; 121(2): 229-34.
 [http://dx.doi.org/10.1542/peds.2007-0484 ] [PMID:  18245412]

[163]
Del Mar CB, Glasziou PP, Spinks AB. Antibiotics for sore throat. Cochrane Database Syst Rev  2006; (4): CD000023.
 [http://dx.doi.org/10.1002/14651858.CD000023.pub3] [PMID:  17054126]

[164]
Randolph MF, Gerber MA, DeMeo KK, Wright L. Effect of antibiotic therapy on the clinical course of streptococcal pharyngitis. J Pediatr  1985; 106(6): 870-5.
 [http://dx.doi.org/10.1016/S0022-3476(85)80228-6 ] [PMID:  3923180]

[165]
Spinks A, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Libr  2013; 2013(11): CD000023.
 [http://dx.doi.org/10.1002/14651858.CD000023.pub4] [PMID:  24190439]

[166]
Van Brusselen D, Vlieghe E, Schelstraete P, et al. Streptococcal pharyngitis in children: To treat or not to treat? Eur J Pediatr  2014; 173(10): 1275-83.
 [http://dx.doi.org/10.1007/s00431-014-2395-2 ] [PMID:  25113742]

[167]
Linder JA, Stafford RS. Antibiotic treatment of adults with sore throat by community primary care physicians: A national survey, 1989-1999. JAMA  2001; 286(10): 1181-6.
 [http://dx.doi.org/10.1001/jama.286.10.1181 ] [PMID:  11559262]

[168]
Neuner JM, Hamel MB, Phillips RS, Bona K, Aronson MD. Diagnosis and management of adults with pharyngitis. A cost-effectiveness analysis. Ann Intern Med  2003; 139(2): 113-22.
 [http://dx.doi.org/10.7326/0003-4819-139-2-200307150-00011 ] [PMID:  12859161]

[169]
Baltimore RS. Re-evaluation of antibiotic treatment of streptococcal pharyngitis. Curr Opin Pediatr  2010; 22(1): 77-82.
 [http://dx.doi.org/10.1097/MOP.0b013e32833502e7] [PMID:  19996970]

[170]
Baltimore RS. Commentary on ‘Different antibiotic treatments for group A streptococcal pharyngitis (Review)’. Evid Based Child Health  2012; 7(1): 84-5.
 [http://dx.doi.org/10.1002/ebch.1807 ] [PMID:  32313520]

[171]
Martin JM. The mysteries of streptococcal pharyngitis. Curr Treat Options Pediatr  2015; 1(2): 180-9.
 [http://dx.doi.org/10.1007/s40746-015-0013-9 ] [PMID:  26146604]

[172]
van Driel ML, De Sutter AI, Keber N, Habraken H, Christiaens T. Different antibiotic treatments for group A streptococcal pharyngitis. Cochrane Database Syst Rev  2013; (4): CD004406.
 [http://dx.doi.org/10.1002/14651858.CD004406.pub3] [PMID:  23633318]

[173]
Rimoin AW, Hoff NA, Fischer Walker CL, et al. Treatment of streptococcal pharyngitis with once-daily amoxicillin versus intramuscular benzathine penicillin G in low-resource settings: A randomized controlled trial. Clin Pediatr  2011; 50(6): 535-42.
 [http://dx.doi.org/10.1177/0009922810394838 ] [PMID:  21317198]

[174]
Regoli M, Chiappini E, Bonsignori F, Galli L, de Martino M. Update on the management of acute pharyngitis in children. Ital J Pediatr  2011; 37(1): 10.
 [http://dx.doi.org/10.1186/1824-7288-37-10 ] [PMID:  21281502]

[175]
Andrews M, Condren M. Once-daily amoxicillin for pharyngitis. J Pediatr Pharmacol Ther  2010; 15(4): 244-8.
 [http://dx.doi.org/10.5863/1551-6776-15.4.244 ] [PMID:  22477812]

[176]
Lennon DR, Farrell E, Martin DR, Stewart JM. Once-daily amoxicillin versus twice-daily penicillin V in group A -haemolytic streptococcal pharyngitis. Arch Dis Child  2008; 93(6): 474-8.
 [http://dx.doi.org/10.1136/adc.2006.113506 ] [PMID:  18337284]

[177]
Lennon D, Kerdemelidis M, Arroll B, Sharpe N. Once-daily amoxicillin for Group A Streptococcal (GAS) sore throat as the other first-line option: A clarification of the NZ sore throat guidelines. N Z Med J  2011; 124(1338): 116-9.
 [PMID:  21946973]

[178]
Nakao A, Hisata K, Fujimori M, Matsunaga N, Komatsu M, Shimizu T. Amoxicillin effect on bacterial load in group A streptococcal pharyngitis: Comparison of single and multiple daily dosage regimens. BMC Pediatr  2019; 19(1): 205.
 [http://dx.doi.org/10.1186/s12887-019-1582-8 ] [PMID:  31226961]

[179]
Brook I, Gober AE. Rate of eradication of group A beta-hemolytic streptococci in children with pharyngo-tonsillitis by amoxicillin and cefdinir. Int J Pediatr Otorhinolaryngol  2009; 73(5): 757-9.
 [http://dx.doi.org/10.1016/j.ijporl.2009.02.004 ] [PMID:  19285734]

[180]
Casey JR, Pichichero ME. Meta-analysis of cephalosporins versus penicillin for treatment of group A streptococcal tonsillopharyngitis in adults. Clin Infect Dis  2004; 38(11): 1526-34.
 [http://dx.doi.org/10.1086/392496 ] [PMID:  15156437]

[181]
Hoban DJ, Nauta J. Clinical and bacteriological impact of clarithromycin in streptococcal pharyngitis: Findings from a meta-analysis of clinical trials. Drug Des Devel Ther  2019; 13: 3551-8.
 [http://dx.doi.org/10.2147/DDDT.S205820 ] [PMID:  31802844]

[182]
Casey JR, Pichichero ME. Higher dosages of azithromycin are more effective in treatment of group A streptococcal tonsillopharyngitis. Clin Infect Dis  2005; 40(12): 1748-55.
 [http://dx.doi.org/10.1086/430307 ] [PMID:  15909262]

[183]
Petrelli D, Di Luca MC, Prenna M, Bernaschi P, Repetto A, Vitali LA. Characterization of levofloxacin non-susceptible clinical Streptococcus pyogenes isolated in the central part of Italy. Eur J Clin Microbiol Infect Dis  2014; 33(2): 241-4.
 [http://dx.doi.org/10.1007/s10096-013-1950-5 ] [PMID:  24002218]

[184]
Logan LK, McAuley JB, Shulman ST. Macrolide treatment failure in streptococcal pharyngitis resulting in acute rheumatic fever. Pediatrics  2012; 129(3): e798-802.
 [http://dx.doi.org/10.1542/peds.2011-1198 ] [PMID:  22311996]

[185]
Lin JN, Chang LL, Lai CH, et al. High prevalence of fluoroquinolone-nonsusceptible Streptococcus pyogenes emm12 in Taiwan. Diagn Microbiol Infect Dis  2015; 83(2): 187-92.
 [http://dx.doi.org/10.1016/j.diagmicrobio.2015.06.018] [PMID:  26234479]

[186]
Palmieri C, Vecchi M, Littauer P, Sundsfjord A, Varaldo PE, Facinelli B. Clonal spread of macrolide- and tetracycline-resistant [erm(A) tet(O)] emm77 Streptococcus pyogenes isolates in Italy and Norway. Antimicrob Agents Chemother  2006; 50(12): 4229-30.
 [http://dx.doi.org/10.1128/AAC.00943-06 ] [PMID:  17043129]

[187]
Richter SS, Heilmann KP, Beekmann SE, et al. Macrolide-resistant streptococcus pyogenes in the united states, 2002-2003. Clin Infect Dis  2005; 41(5): 599-608.
 [http://dx.doi.org/10.1086/432473 ] [PMID:  16080080]

[188]
Van Heirstraeten L, Leten G, Lammens C, Goossens H, Malhotra-Kumar S. Increase in fluoroquinolone non-susceptibility among clinical Streptococcus pyogenes in Belgium during 2007-10. J Antimicrob Chemother  2012; 67(11): 2602-5.
 [http://dx.doi.org/10.1093/jac/dks281 ] [PMID:  22815354]

[189]
Sakata H. Comparative study of 5-day cefcapene-pivoxil and 10-day amoxicillin or cefcapene-pivoxil for treatment of group A streptococcal pharyngitis in children. J Infect Chemother  2008; 14(3): 208-12.
 [http://dx.doi.org/10.1007/s10156-008-0597-0 ] [PMID:  18574656]

[190]
Salinas Salvador B, Moreno Sánchez A, Carmen Marcén G. Retrospective study on the effectiveness and safety of the shortened 5- to 7-day antibiotic regimen for acute streptococcal pharyngotonsillitis compared to the classic 10-day regimen. An Pediatr  2022; 97(6): 398-404.
 [http://dx.doi.org/10.1016/j.anpede.2022.07.005]

[191]
Schaad UB, Kellerhals P, Altwegg M. Azithromycin versus penicillin V for treatment of acute group A streptococcal pharyngitis. Pediatr Infect Dis J  2002; 21(4): 304-8.
 [http://dx.doi.org/10.1097/00006454-200204000-00009] [PMID:  12075761]

[192]
Tell D, Tyrstrup M, Edlund C, et al. Clinical course of pharyngotonsillitis with group A streptococcus treated with different penicillin V strategies, divided in groups of Centor Score 3 and 4: A prospective study in primary care. BMC Infect Dis  2022; 22(1): 840.
 [http://dx.doi.org/10.1186/s12879-022-07830-4 ] [PMID:  36368940]

[193]
Wightman S. A 5-day course of penicillin V may be an effective treatment for streptococcal pharyngitis. Arch Dis Child Educ Pract Ed  2020; 106(5): edpract-2019-318740.
 [http://dx.doi.org/10.1136/archdischild-2019-318740] [PMID:  32198212]

[194]
Altamimi S, Khalil A, Khalaiwi KA, Milner RA, Pusic MV, Al Othman MA. Short-term late-generation antibiotics versus longer term penicillin for acute streptococcal pharyngitis in children. Cochrane Libr  2012; (8): CD004872.
 [http://dx.doi.org/10.1002/14651858.CD004872.pub3] [PMID:  22895944]

[195]
Kim S. Optimal Diagnosis and treatment of group A streptococcal pharyngitis. Infect Chemother  2015; 47(3): 202-4.
 [http://dx.doi.org/10.3947/ic.2015.47.3.202 ] [PMID:  26483997]

[196]
Llor C, Bjerrum L. Short courses of penicillin for streptococcal pharyngitis are not supported by the evidence. Fam Pract  2018; 35(2): 228-9.
 [http://dx.doi.org/10.1093/fampra/cmx126 ] [PMID:  29244068]

[197]
Barsenga S, Mitiku H, Tesfa T, Shume T. Throat carriage rate, associated factors, and antimicrobial susceptibility pattern of group A Streptococcus among healthy school children in Jigjiga City, Eastern Ethiopia. BMC Pediatr  2022; 22(1): 227.
 [http://dx.doi.org/10.1186/s12887-022-03294-2 ] [PMID:  35473515]

[198]
DeMuri GP, Wald ER. The group A streptococcal carrier state reviewed: Still an enigma. J Pediatric Infect Dis Soc  2014; 3(4): 336-42.
 [http://dx.doi.org/10.1093/jpids/piu030 ] [PMID:  26625454]

[199]
Oliver J, Malliya Wadu E, Pierse N, et al. Group A Streptococcus pharyngitis and pharyngeal carriage: A meta-analysis. PLoS Negl Trop Dis  2018; 12(3): e0006335.
 [http://dx.doi.org/10.1371/journal.pntd.0006335 ] [PMID:  29554121]

[200]
Rick AM, Zaheer HA, Martin JM. Clinical features of group A streptococcus in children with pharyngitis: Carriers versus acute infection. Pediatr Infect Dis J  2020; 39(6): 483-8.
 [http://dx.doi.org/10.1097/INF.0000000000002602] [PMID:  32040013]

[201]
van Driel ML, De Sutter AIM, Habraken H, Thorning S, Christiaens T. Different antibiotic treatments for group A streptococcal pharyngitis. Cochrane Libr  2016; 9(9): CD004406.
 [http://dx.doi.org/10.1002/14651858.CD004406.pub4] [PMID:  27614728]

[202]
Ivaska L, Niemelä J, Gröndahl-Yli-Hannuksela K, et al. Detection of group A streptococcus in children with confirmed viral pharyngitis and antiviral host response. Eur J Pediatr  2022; 181(12): 4059-65.
 [http://dx.doi.org/10.1007/s00431-022-04633-2 ] [PMID:  36163516]

[203]
Wald ER. Tonsillectomy and/or adenoidectomy in children: Indications and contraindications.UpToDate. 

[204]
Leung AKC, Hon KLE, Robson WLM. Atopic dermatitis. Adv Pediatr  2007; 54(1): 241-73.
 [http://dx.doi.org/10.1016/j.yapd.2007.03.013 ] [PMID:  17918474]

[205]
Stead W. Group Symptomatic treatment of acute pharyngitis in adults. UpToDate. 

[206]
Wonnemann M, Helm I, Stauss-Grabo M, et al. Lidocaine 8 mg sore throat lozenges in the treatment of acute pharyngitis. A new therapeutic option investigated in comparison to placebo treatment. Arzneimittelforschung  2011; 57(11): 689-97.
 [http://dx.doi.org/10.1055/s-0031-1296669 ] [PMID:  18193690]

[207]
Aspley S, Shephard A, Schachtel E, Sanner K, Savino L, Schachtel B. Efficacy of flurbiprofen 8.75 mg lozenge in patients with a swollen and inflamed sore throat. Curr Med Res Opin  2016; 32(9): 1529-38.
 [http://dx.doi.org/10.1080/03007995.2016.1187119] [PMID:  27146963]

[208]
Blagden M, Christian J, Miller K, Charlesworth A. Multidose flurbiprofen 8.75 mg lozenges in the treatment of sore throat: A randomised, double-blind, placebo-controlled study in UK general practice centres. Int J Clin Pract  2002; 56(2): 95-100.
 [http://dx.doi.org/10.1111/j.1742-1241.2002.tb11204.x] [PMID:  11926713]

[209]
Bouroubi A, Donazzolo Y, Donath F, et al. Pain relief of sore throat with a new anti-inflammatory throat lozenge, ibuprofen 25 mg: A randomised, double-blind, placebo-controlled, international phase III study. Int J Clin Pract  2017; 71(9): e12961.
 [http://dx.doi.org/10.1111/ijcp.12961 ] [PMID:  28869722]

[210]
Buchholz V, Leuwer M, Ahrens J, Foadi N, Krampfl K, Haeseler G. Topical antiseptics for the treatment of sore throat block voltage-gated neuronal sodium channels in a local anaesthetic-like manner. Naunyn Schmiedebergs Arch Pharmacol  2009; 380(2): 161-8.
 [http://dx.doi.org/10.1007/s00210-009-0416-x ] [PMID:  19367399]

[211]
Chrubasik S, Beime B, Magora F. Efficacy of a benzocaine lozenge in the treatment of uncomplicated sore throat. Eur Arch Otorhinolaryngol  2012; 269(2): 571-7.
 [http://dx.doi.org/10.1007/s00405-011-1802-9 ] [PMID:  22015737]

[212]
Cingi C, Songu M, Ural A, Yildirim M, Erdogmus N, Bal C. Effects of chlorhexidine/benzydamine mouth spray on pain and quality of life in acute viral pharyngitis: A prospective, randomized, double-blind, placebo-controlled, multicenter study. Ear Nose Throat J  2010; 89(11): 546-9.
 [PMID:  21086279]

[213]
Cingi C, Songu M, Ural A, et al. Effect of chlorhexidine gluconate and benzydamine hydrochloride mouth spray on clinical signs and quality of life of patients with streptococcal tonsillopharyngitis: Multicentre, prospective, randomised, double-blinded, placebo-controlled study. J Laryngol Otol  2011; 125(6): 620-5.
 [http://dx.doi.org/10.1017/S0022215111000065 ] [PMID:  21310101]

[214]
Mey C, Peil H, Kölsch S, Bubeck J, Vix JM. Efficacy and safety of ambroxol lozenges in the treatment of acute uncomplicated sore throat. EBM-based clinical documentation. Arzneimittelforschung  2011; 58(11): 557-68.
 [http://dx.doi.org/10.1055/s-0031-1296557 ] [PMID:  19137906]

[215]
Fischer J, Pschorn U, Vix JM, et al. Efficacy and tolerability of ambroxol hydrochloride lozenges in sore throat. Randomised, double-blind, placebo-controlled trials regarding the local anaesthetic properties. Arzneimittelforschung  2011; 52(4): 256-63.
 [http://dx.doi.org/10.1055/s-0031-1299889 ] [PMID:  12040968]

[216]
McNally D, Simpson M, Morris C, Shephard A, Goulder M. Rapid relief of acute sore throat with AMC/DCBA throat lozenges: Randomised controlled trial. Int J Clin Pract  2010; 64(2): 194-207.
 [http://dx.doi.org/10.1111/j.1742-1241.2009.02230.x] [PMID:  19849767]

[217]
McNally D, Shephard A, Field E. Randomised, double-blind, placebo-controlled study of a single dose of an amylmetacresol/2,4-dichlorobenzyl alcohol plus lidocaine lozenge or a hexylresorcinol lozenge for the treatment of acute sore throat due to upper respiratory tract infection. J Pharm Pharm Sci  2012; 15(2): 281-94.
 [http://dx.doi.org/10.18433/J31309 ] [PMID:  22579007]

[218]
Palm J, Fuchs K, Stammer H, Schumacher-Stimpfl A, Milde J. Efficacy and safety of a triple active sore throat lozenge in the treatment of patients with acute pharyngitis: Results of a multi-centre, randomised, placebo-controlled, double-blind, parallel-group trial (DoriPha). Int J Clin Pract  2018; 72(12): e13272.
 [http://dx.doi.org/10.1111/ijcp.13272 ] [PMID:  30329199]

[219]
Schachtel B, Aspley S, Shephard A, et al. Onset of action of a lozenge containing flurbiprofen 8.75 mg: A randomized, double-blind, placebo-controlled trial with a new method for measuring onset of analgesic activity. Pain  2014; 155(2): 422-8.
 [http://dx.doi.org/10.1016/j.pain.2013.11.001 ] [PMID:  24231654]

[220]
Schachtel B, Shephard A, Schachtel E, Shea T, Smith A, Tselenti E. Evidence of the efficacy of flurbiprofen 8.75 mg lozenges for patients receiving antibiotics for laboratory-confirmed streptococcal pharyngitis. Ear Nose Throat J  2021; 1455613211025754
 [http://dx.doi.org/10.1177/01455613211025754] [PMID:  34261371]

[221]
Schutz A, Gund HJ, Pschorn U, et al. Local anaesthetic properties of ambroxol hydrochloride lozenges in view of sore throat. Clinical proof of concept. Arzneimittelforschung  2011; 52(3): 194-9.
 [http://dx.doi.org/10.1055/s-0031-1299879 ] [PMID:  11963647]

[222]
Shephard A, Smith G, Aspley S, Schachtel BP. Randomised, double-blind, placebo-controlled studies on flurbiprofen 8.75 mg lozenges in patients with/without group A or C streptococcal throat infection, with an assessment of clinicians’ prediction of ‘strep throat’. Int J Clin Pract  2015; 69(1): 59-71.
 [http://dx.doi.org/10.1111/ijcp.12536 ] [PMID:  25296661]

[223]
Thomas M, Del Mar C, Glasziou P. How effective are treatments other than antibiotics for acute sore throat? Br J Gen Pract  2000; 50(459): 817-20.
 [PMID:  11127175]

[224]
Wade AG, Morris C, Shephard A, Crawford GM, Goulder MA. A multicentre, randomised, double-blind, single-dose study assessing the efficacy of AMC/DCBA Warm lozenge or AMC/DCBA Cool lozenge in the relief of acute sore throat. BMC Fam Pract  2011; 12(1): 6.
 [http://dx.doi.org/10.1186/1471-2296-12-6 ] [PMID:  21332976]

[225]
Watt EE, Betts BA, Kotey FO, et al. Menthol shares general anesthetic activity and sites of action on the GABAA receptor with the intravenous agent, propofol. Eur J Pharmacol  2008; 590(1-3): 120-6.
 [http://dx.doi.org/10.1016/j.ejphar.2008.06.003 ] [PMID:  18593637]

[226]
Jiang X, Lin A, Li S, et al. Effects of artificial honey and epigallocatechin-3-gallate on streptococcus pyogenes. BMC Microbiol  2022; 22(1): 207.
 [http://dx.doi.org/10.1186/s12866-022-02611-0 ] [PMID:  36028794]

[227]
Otręba M, Marek Ł, Tyczyńska N, Stojko J, Rzepecka-Stojko A. Bee venom, honey, and Royal jelly in the treatment of bacterial infections of the oral cavity: A review. Life  2021; 11(12): 1311.
 [http://dx.doi.org/10.3390/life11121311 ] [PMID:  34947842]

[228]
Abdulraheem Al-Kafaween M, Al-Jamal HA, Mohd Hilmi AB, Elsahoryi NA, Jaffar N, Khairi Zahri M. Antibacterial properties of selected Malaysian Tualang honey against Pseudomonas aeruginosa and Streptococcus pyogenes. Iran J Microbiol  2020; 12(6): 565-76.
 [http://dx.doi.org/10.18502/ijm.v12i6.5031 ] [PMID:  33613911]

[229]
Al-kafaween MA, Al-Jamal HAN. A comparative study of antibacterial and antivirulence activities of four selected honeys to Manuka honey. Iran J Microbiol  2022; 14(2): 238-51.
 [http://dx.doi.org/10.18502/ijm.v14i2.9193 ] [PMID:  35765547]

[230]
Maddocks SE, Lopez MS, Rowlands RS, Cooper RA. Manuka honey inhibits the development of Streptococcus pyogenes biofilms and causes reduced expression of two fibronectin binding proteins. Microbiology  2012; 158(3): 781-90.
 [http://dx.doi.org/10.1099/mic.0.053959-0 ] [PMID:  22294681]

[231]
Maddocks SE, Jenkins RE, Rowlands RS, Purdy KJ, Cooper RA. Manuka honey inhibits adhesion and invasion of medically important wound bacteria in vitro. Future Microbiol  2013; 8(12): 1523-36.
 [http://dx.doi.org/10.2217/fmb.13.126 ] [PMID:  24266353]

[232]
Moussa A, Noureddine D, Mohamed HS, Abdelmelek M, Saad A. Antibacterial activity of various honey types of algeria against staphylococcus aureus and streptococcus pyogenes. Asian Pac J Trop Med  2012; 5(10): 773-6.
 [http://dx.doi.org/10.1016/S1995-7645(12)60141-2] [PMID:  23043914]

[233]
Huang Y, Wu T, Zeng L, Li S. Chinese medicinal herbs for sore throat. Cochrane Libr  2012; (3): CD004877.
 [http://dx.doi.org/10.1002/14651858.CD004877.pub3] [PMID:  22419300]

[234]
Abachi S, Macé S, Lee S, Rupasinghe HPV. Cranberry and sumac extracts exhibit antibacterial and anti-adhesive effects against Streptococcus pyogenes. J Med Food  2022; 25(4): 426-34.
 [http://dx.doi.org/10.1089/jmf.2021.0047 ] [PMID:  35076261]

[235]
Adil M, Khan R, Rupasinghe HPV. Application of medicinal plants as a source for therapeutic agents against Streptococcus pyogenes infections. Curr Drug Metab  2018; 19(8): 695-703.
 [http://dx.doi.org/10.2174/1389200219666180329150551] [PMID:  29595103]

[236]
Brinckmann J, Sigwart H, van Houten Taylor L. Safety and efficacy of a traditional herbal medicine (Throat Coat) in symptomatic temporary relief of pain in patients with acute pharyngitis: A multicenter, prospective, randomized, double-blinded, placebo-controlled study. J Altern Complement Med  2003; 9(2): 285-98.
 [http://dx.doi.org/10.1089/10755530360623400 ] [PMID:  12804082]

[237]
Wijesundara NM, Rupasinghe HPV. Essential oils from Origanum vulgare and Salvia officinalis exhibit antibacterial and anti-biofilm activities against Streptococcus pyogenes. Microb Pathog  2018; 117: 118-27.
 [http://dx.doi.org/10.1016/j.micpath.2018.02.026 ] [PMID:  29452197]

[238]
Wijesundara NM, Rupasinghe HPV. Herbal tea for the management of pharyngitis: Inhibition of Streptococcus pyogenes growth and biofilm formation by herbal infusions. Biomedicines  2019; 7(3): 63.
 [http://dx.doi.org/10.3390/biomedicines7030063 ] [PMID:  31450579]

[239]
Wijesundara N, Rupasinghe H. Bactericidal and anti-biofilm activity of ethanol extracts derived from selected medicinal plants against Streptococcus pyogenes. Molecules  2019; 24(6): 1165.
 [http://dx.doi.org/10.3390/molecules24061165 ] [PMID:  30909644]

[240]
Wijesundara NM, Lee SF, Cheng Z, Davidson R, Langelaan DN, Rupasinghe HPV. Bactericidal activity of Carvacrol against Streptococcus pyogenes involves alteration of membrane fluidity and integrity through interaction with membrane phospholipids. Pharmaceutics  2022; 14(10): 1992.
 [http://dx.doi.org/10.3390/pharmaceutics14101992] [PMID:  36297428]

[241]
Di Pierro F, Donato G, Fomia F, et al. Preliminary pediatric clinical evaluation of the oral probiotic Streptococcus salivarius K12 in preventing recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes and recurrent acute otitis media. Int J Gen Med  2012; 5: 991-7.
 [http://dx.doi.org/10.2147/IJGM.S38859 ] [PMID:  23233809]

[242]
Di Pierro F, Adami T, Rapacioli G, Giardini N, Streitberger C. Clinical evaluation of the oral probiotic Streptococcus salivarius K12 in the prevention of recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes in adults. Expert Opin Biol Ther  2013; 13(3): 339-43.
 [http://dx.doi.org/10.1517/14712598.2013.758711 ] [PMID:  23286823]

[243]
Di Pierro F, Colombo M, Zanvit A, Risso P, Rottoli A. Use of Streptococcus salivarius K12 in the prevention of streptococcal and viral pharyngotonsillitis in children. Drug Healthc Patient Saf  2014; 6: 15-20.
 [http://dx.doi.org/10.2147/DHPS.S59665 ] [PMID:  24600248]

[244]
Di Pierro F, Colombo M, Giuliani MG, et al. Effect of administration of Streptococcus salivarius K12 on the occurrence of streptococcal pharyngo-tonsillitis, scarlet fever and acute otitis media in 3 years old children. Eur Rev Med Pharmacol Sci  2016; 20(21): 4601-6.
 [PMID:  27874935]

[245]
Di Pierro F, Colombo M, Zanvit A, Rottoli AS. Positive clinical outcomes derived from using Streptococcus salivarius K12 to prevent streptococcal pharyngotonsillitis in children: A pilot investigation. Drug Healthc Patient Saf  2016; 8: 77-81.
 [http://dx.doi.org/10.2147/DHPS.S117214 ] [PMID:  27920580]

[246]
Di Pierro F, Risso P, Poggi E, et al. Use of Streptococcus salivarius K12 to reduce the incidence of pharyngo-tonsillitis and acute otitis media in children: A retrospective analysis in not-recurrent pediatric subjects. Minerva Pediatr  2018; 70(3): 240-5.
 [http://dx.doi.org/10.23736/S0026-4946.18.05182-4] [PMID:  29322750]

[247]
Di Pierro F. Assessment of efficacy of BLIS-producing probiotic K12 for the prevention of Group A streptococcus pharyngitis: A short communication. Probiotics Antimicrob Proteins  2019; 11(1): 332-4.
 [http://dx.doi.org/10.1007/s12602-018-9398-7 ] [PMID:  29464500]

[248]
Doyle H, Pierse N, Tiatia R, Williamson D, Baker M, Crane J. Effect of oral probiotic Streptococcus salivarius K12 on Group A streptococcus pharyngitis: A pragmatic trial in schools. Pediatr Infect Dis J  2018; 37(7): 619-23.
 [http://dx.doi.org/10.1097/INF.0000000000001847] [PMID:  29189607]

[249]
Gregori G, Righi O, Risso P, et al. Reduction of group A beta-hemolytic streptococcus pharyngo-tonsillar infections associated with use of the oral probiotic Streptococcus salivarius K12: A retrospective observational study. Ther Clin Risk Manag  2016; 12: 87-92.
 [http://dx.doi.org/10.2147/TCRM.S96134 ] [PMID:  26855579]

[250]
Andrejko K, Whittles LK, Lewnard JA. Health-economic value of vaccination against group A streptococcus in the United States. Clin Infect Dis  2022; 74(6): 983-92.
 [http://dx.doi.org/10.1093/cid/ciab597 ] [PMID:  34192307]

[251]
Di Benedetto R, Mancini F, Carducci M, et al. Rational design of a glycoconjugate vaccine against group A streptococcus. Int J Mol Sci  2020; 21(22): 8558.
 [http://dx.doi.org/10.3390/ijms21228558 ] [PMID:  33202815]

[252]
Baums CG, Kaim U, Fulde M, Ramachandran G, Goethe R, Valentin-Weigand P. Identification of a novel virulence determinant with serum opacification activity in Streptococcus suis. Infect Immun  2006; 74(11): 6154-62.
 [http://dx.doi.org/10.1128/IAI.00359-06 ] [PMID:  17057090]

[253]
Hu MC, Walls MA, Stroop SD, Reddish MA, Beall B, Dale JB. Immunogenicity of a 26-valent group A streptococcal vaccine. Infect Immun  2002; 70(4): 2171-7.
 [http://dx.doi.org/10.1128/IAI.70.4.2171-2177.2002] [PMID:  11895984]

[254]
McNeil SA, Halperin SA, Langley JM, et al. Safety and immunogenicity of 26-valent group a streptococcus vaccine in healthy adult volunteers. Clin Infect Dis  2005; 41(8): 1114-22.
 [http://dx.doi.org/10.1086/444458 ] [PMID:  16163629]

[255]
Sekuloski S, Batzloff MR, Griffin P, et al. Evaluation of safety and immunogenicity of a group A streptococcus vaccine candidate (MJ8VAX) in a randomized clinical trial. PLoS One  2018; 13(7): e0198658.
 [http://dx.doi.org/10.1371/journal.pone.0198658 ] [PMID:  29965967]

[256]
Castro SA, Dorfmueller HC. A brief review on Group A Streptococcus pathogenesis and vaccine development. R Soc Open Sci  2021; 8(3): 201991.
 [http://dx.doi.org/10.1098/rsos.201991 ] [PMID:  33959354]

[257]
Fischetti VA. Vaccine approaches to protect against group A streptococcal pharyngitis. Microbiol Spectr  2019; 7(3): 7.3.2.
 [http://dx.doi.org/10.1128/microbiolspec.GPP3-0010-2018] [PMID: 31111819]

[258]
Giffard PM, Tong SYC, Holt DC, Ralph AP, Currie BJ. Concerns for efficacy of a 30-valent M-protein-based Streptococcus pyogenes vaccine in regions with high rates of rheumatic heart disease. PLoS Negl Trop Dis  2019; 13(7): e0007511.
 [http://dx.doi.org/10.1371/journal.pntd.0007511 ] [PMID:  31269021]

[259]
Pastural É, McNeil SA, MacKinnon-Cameron D, et al. Safety and immunogenicity of a 30-valent M protein-based group a streptococcal vaccine in healthy adult volunteers: A randomized, controlled phase I study. Vaccine  2020; 38(6): 1384-92.
 [http://dx.doi.org/10.1016/j.vaccine.2019.12.005 ] [PMID:  31843270]

[260]
Bateman E, Mansour S, Okafor E, Arrington K, Hong BY, Cervantes J. Examining the efficacy of antimicrobial therapy in preventing the development of postinfectious glomerulonephritis: A systematic review and meta-analysis. Infect Dis Rep  2022; 14(2): 176-83.
 [http://dx.doi.org/10.3390/idr14020022 ] [PMID:  35314652]

[261]
Maness DL, Martin M, Mitchell G. Poststreptococcal illness: Recognition and management. Am Fam Physician  2018; 97(8): 517-22.
 [PMID:  29671499]

[262]
Sainato RJ, Weisse ME. Poststreptococcal glomerulonephritis and antibiotics: A fresh look at old data. Clin Pediatr  2019; 58(1): 10-2.
 [http://dx.doi.org/10.1177/0009922818793345] [PMID:  30095005]
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DOI https://dx.doi.org/10.2174/1573396320666230726145436	Print ISSN 1573-3963
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Current Pediatric Reviews

Group A β-hemolytic Streptococcal Pharyngitis: An Updated Review

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Early-life nutrition: impacts on health and diseases

Current Pediatric Reviews

Group A β-hemolytic Streptococcal Pharyngitis: An Updated Review

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