Overview of 2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on Group A Streptococcal (GAS) Pharyngitis: Risk Assessment Using Clinical Scoring Systems in Children and Adults
Clinical Infectious Diseases·
- DOI
- 10.1093/cid/ciag098
- PMID
- 41692530
- PMCID
- —
- OpenAlex
- —
- Study type
- Systematic review
- Publisher
- Oxford University Press (OUP)
- Article type
- journal-article
- Integrity
- current
Why this research matters now
Universal testing for GAS pharyngitis incurs cost and inconvenience for low-risk individuals, while clinician judgment alone is unreliable. Standardized clinical scoring systems may improve diagnostic triage, helping to identify which patients warrant testing based on criteria including fever, tonsillar findings, cervical lymphadenopathy, and absence of cough.
Structured evidence summary
Research question
The guideline update evaluates whether clinical scoring systems should be used to determine which patients with sore throat require diagnostic testing for group A streptococcal pharyngitis.
Study design
This is a systematic review of randomized and non-randomized studies comparing clinical scoring systems to clinician judgment alone in predicting throat culture results for GAS pharyngitis.
Population and setting
The review includes studies of children and adults presenting with sore throat and suspected group A streptococcal pharyngitis.
Main findings
Evidence suggests diagnostic accuracy using clinical scoring systems is comparable or slightly higher than clinician judgment alone. The panel consensus favors incorporating clinical scoring systems into the evaluation of patients with suspected GAS pharyngitis, as the balance of benefits and harms supports this approach.
Public-health relevance
Universal testing for GAS pharyngitis incurs cost and inconvenience for low-risk individuals, while clinician judgment alone is unreliable. Standardized clinical scoring systems may improve diagnostic triage, helping to identify which patients warrant testing based on criteria including fever, tonsillar findings, cervical lymphadenopathy, and absence of cough.
Important limitations
The included studies are limited by small sample sizes, lack of uniformity in outcome measures, and incomplete data.
GIDS interpretation
This guideline update would be discoverable through queries for group A streptococcal pharyngitis, diagnostic approaches, and clinical decision tools for bacterial pharyngitis. It provides context on standardized risk assessment methods that may influence testing practices in primary care and infectious disease settings.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 8 auditable classifier relationships to diseases, places, topics, and study design.