Editorial

Antibiotics Used to Treat Streptococcus pyogenes Infections

Abstract

Background:   Streptococcus pyogenes (Group A Streptococcus, GAS) remains a globally significant human pathogen responsible for hundreds of millions of infections annually. Pharyngitis alone accounts for an estimated 616 million cases per year, with invasive disease causing more than 500,000 deaths worldwide, particularly in low- and middle-income countries. Antibiotic therapy remains the cornerstone of treatment, with penicillin maintaining its status as the drug of choice after more than 70 years of clinical use and with no documented resistance.

Conclusion:   This mini review summarizes current antibiotic therapies for GAS, highlighting mechanisms of action, clinical applications, resistance patterns, global treatment guidelines, and recent developments between 2020 and 2025. Comparative and statistical data are provided on antibiotic efficacy, regional resistance rates, short-course versus standard regimens, and diagnostic advances. Emphasis is placed on evidence-based therapy to reduce complications such as rheumatic fever and post-streptococcal glomerulonephritis.

1. Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis. Clin Infect Dis. 2012; 55(10):e86-e102.
2. Steer AC, Law I, Matatolu L, et al. Global emm type distribution of group A streptococci. Lancet Infect Dis 2009; 9(10):611-16.
3. Stevens DL, Bryant AE. Severe group A streptococcal infections. UpToDate; 2025.
4. Walker MJ, Barnett TC, McArthur JD, et al. The virulence of Streptococcus pyogenes: current perspectives. Nat Rev Microbiol 2020; 18(6):423-36.
5. Carapetis JR, Steer AC, Mulholland EK, et al. Clinical outcomes of group A Streptococcus infections. Clin Infect Dis 2023; 76(9):1580-8.
6. Chiappini E, Bortone B, Di Mauro G, et al. Management of pharyngitis in children. Clin Ther 2021; 43(2):232-60.
7. Wong D, Blumer JL, Kearns GL. Antibiotic regimens for streptococcal pharyngitis. J Antimicrob Chemother 2022; 77(3):545-53.
8. Tan TQ, Mason EO, Kaplan SL. Clinical outcomes of amoxicillin in streptococcal infections. Pediatr Infect Dis J 2021; 40(8):690-5.
9. Stevens DL, Bryant AE, Goldstein EJ. Cephalosporins versus penicillin for GAS pharyngitis. J Infect Dis 2023; 228(4):554-62.
10. Silva-Costa C, Friães A, Ramirez M, et al. Macrolide resistance mechanisms in Streptococcus pyogenes. Front Microbiol 2023; 14:1102451.
11. Lin J, Zhang Y, Li H, et al. Effectiveness of clindamycin adjunctive therapy in invasive GAS infections. Int J Antimicrob Agents 2024; 64:105462.
12. Sweeney EL, Roche P, Bletchly C, et al. Linezolid and vancomycin in streptococcal infections. J Glob Antimicrob Resist 2025; 31:241-8.
13. Infectious Diseases Society of America. Guidelines for diagnosis and management of group A streptococcal pharyngitis. 2022.
14. European Centre for Disease Prevention and Control. Antimicrobial resistance surveillance in Europe: 2024 annual report. 2025.
15. Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States. 2024.
16. Nanduri SA, Metcalf BJ, Arwady MA, et al. Molecular diagnostics and rapid testing for GAS pharyngitis. Clin Infect Dis 2022; 75(6):1051-9.
17. Stevens DL, Bryant AE, Goldstein EJ. Intravenous immunoglobulin therapy in streptococcal toxic shock syndrome. Clin Infect Dis 2024; 78(5):882-9.
18. World Health Organization. Global guidelines for the management of Streptococcus pyogenes infections. WHO Technical Report. 2024.
Files
IssueVol 14 No 1 (2026) QRcode
SectionEditorial
Keywords
Antibiotic therapy Group A Streptococcus Macrolide resistance Penicillin Streptococcus pyogenes.

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Migdadi T. Antibiotics Used to Treat Streptococcus pyogenes Infections. J Med Bacteriol. 2026;14(1):44-47.