It is difficult to know if an acute sore throat is due to a virus or Streptococcus. Therefore, antibiotics should be given to all children under 15 years who have a fever and sore throat (pharyngitis) without the signs of a common cold, i.e. blocked nose and nasal discharge. Oral penicillin, amoxycillin or erythromycin for 5 days are needed. However, it is also important that antibiotics are not given to all children with a viral upper respiratory tract infections such as the common cold or influenza.

With the more frequent use of antibiotics, acute rheumatic fever has become uncommon in wealthy countries.