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  • Title: Group A Streptococcal (GAS) Pharyngitis: Risk Assessment Using Clinical Scoring Systems in Children and Adults
  • Society: Infectious Diseases Society of America
  • Publish Date: October 14, 2025
  • Summary
  • Full-text

Video Transcription

Just published October 14, 2025 - The Infectious Diseases Society of America’s newest guideline on Group A Streptococcal (GAS) Pharyngitis: Risk Assessment Using Clinical Scoring Systems in Children and Adults.

The objective of this guideline is to determine whether a scoring system should be used to decide which patients should have a diagnostic test performed by rapid antigen detection test, molecular methods, and/or throat culture.

There are is 1 recommendation with 4 remarks, so let’s get started:

  • In children and adults with sore throat, the guideline suggests using a clinical scoring system to determine who should be tested for GAS.
  1. High-risk individuals should be strongly considered for testing even if their clinical scores are low. Examples of high-risk individuals include those presenting with sore throat who have had household exposure to GAS, a history of a previous rheumatic fever diagnosis, or symptoms or signs suggestive of complicated local or systemic GAS infection.
  2. The panel recommends that a clinical scoring system be used as part of the evaluation of patients with sore throat. The principal utility of a scoring system is to identify patients with low probability of GAS pharyngitis, in whom further evaluation by diagnostic testing is unlikely to be helpful.
  3. Given the lack of evidence favoring any particular scoring system, clinicians and patients may favor clinical scoring systems that do not include laboratory test(s).
  4. The recommendation to use a scoring system does not apply to children under three years of age as GAS infection in this age group may not present with typical clinical features represented in these scoring systems.

And there you have it. Make sure to check out the full guideline from The Infectious Diseases Society of America and other related clinical decision support tools at guidelinecentral.com.

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