ID Corner: A Sore Subject: What’s New in Streptococcal Pharyngitis Scoring and Diagnosis
by Anna Erickson, PharmD, Tracy Zembles, PharmD, BCPS, BCIDP, FIDP
The 2025 Infectious Diseases Society of America update to the group A streptococcal (GAS) pharyngitis guideline introduces a more selective approach to testing patients with sore throat. Rather than broadly testing patients without clear viral symptoms, the updated guidance recommends using clinical scoring tools, including Centor, McIsaac, and FeverPAIN, to identify patients at low risk for GAS who may not require diagnostic testing.
This article reviews the role of these scoring tools, appropriate use of rapid antigen detection tests and throat cultures, and current treatment recommendations for confirmed GAS pharyngitis. It also highlights the importance of distinguishing viral and bacterial symptoms, recognizing patients who warrant testing despite a low score, and supporting antibiotic stewardship. Pharmacists can help apply these practical screening approaches in community, emergency department, and multidisciplinary care settings to reduce unnecessary testing and antibiotic exposure while maintaining high-quality patient care.
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2026 July/August Table of Contents
The 2025 Infectious Diseases Society of America update to the group A streptococcal (GAS) pharyngitis guideline introduces a more selective approach to testing patients with sore throat. Rather than broadly testing patients without clear viral symptoms, the updated guidance recommends using clinical scoring tools, including Centor, McIsaac, and FeverPAIN, to identify patients at low risk for GAS who may not require diagnostic testing.
This article reviews the role of these scoring tools, appropriate use of rapid antigen detection tests and throat cultures, and current treatment recommendations for confirmed GAS pharyngitis. It also highlights the importance of distinguishing viral and bacterial symptoms, recognizing patients who warrant testing despite a low score, and supporting antibiotic stewardship. Pharmacists can help apply these practical screening approaches in community, emergency department, and multidisciplinary care settings to reduce unnecessary testing and antibiotic exposure while maintaining high-quality patient care.
Download PDF
2026 July/August Table of Contents