Background: Streptococcal pharyngitis is a common presentation to primary care and Emergency Department physicians. Every year, 10 million patients in the United States are treated with antibiotics for pharyngitis. However, less than 10% of these patients actually have strep pharyngitis (Barnett 2013). Prescribing of antibiotics for these patients centers on three arguments:

1. Antibiotics reduce symptomology
2. Antibiotics reduce the rate of suppurative complications
3. Antibiotics reduce the rate of non-suppurative complications (primarily Rheumatic Heart Disease).

So, do patients with strep throat need to be treated with antibiotics?

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