Group A streptococcal pharyngitis — MCCQE Part 1 MCQ

Correct answer: C — Perform throat swab/rapid testing and treat if positive

Perform throat swab/rapid testing and treat if positive is best because clinical features raise the probability but testing helps avoid unnecessary antibiotics. Provide only reassurance without clear follow-up or safety-netting is suboptimal because children can deteriorate quickly and follow-up must be explicit; Use adult dosing or adult pathways without paediatric adjustment is suboptimal because children require age- and weight-appropriate care; Delay assessment until the next routine visit is suboptimal because developmental, infectious and neonatal red flags require timely assessment; Give antibiotics, steroids or investigations routinely despite no indication is suboptimal because over-treatment can cause harm when supportive or targeted care is indicated. Canadian practice emphasises antimicrobial stewardship.

Reference: Canadian Paediatric Society guidance