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Recently, recommendations from the American Heart Association regarding treatment of streptococcal tonsillo-pharyngitis were revised. This review provides the background for changes that were made in comparison with the group's 1995 recommendations. Recent papers on other issues relating to group A Streptococcus are also reviewed.For antibiotic treatment of streptococcal tonsillopharyngitis the recommendations for injectable penicillin and for oral erythromycin are downgraded. First choice remains penicillin V but there is increasing acceptance of once-daily amoxicillin.Streptococcal pharyngitis is still a major infectious disease seen in pediatric office practice. The main job of the practitioner is to make an accurate diagnosis and provide appropriate treatment in timely fashion in order to prevent acute rheumatic fever.