IDSA diagnostic guidelines include the following:
RADT and/or culture should be performed to distinguish between GAS and viral pharyngitis, except when overt viral features such as rhinorrhea, cough, oral ulcers, and/or hoarseness are present.
In children and adolescents, negative RADT results should be confirmed with a throat culture.
Because of the low incidence of GAS pharyngitis in adults and the exceptionally low risk of subsequent acute rheumatic fever, throat culture after a negative RADT result is not necessary.
Diagnostic testing of asymptomatic household contacts of patients with acute streptococcal pharyngitis is not routinely recommended.
Anti-streptococcal antibody titers are not recommended in the routine diagnosis of acute pharyngitis.
Read more about IDSA guidelines.
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Cite this: Michael Stuart Bronze. Fast Five Quiz: Streptococcal Infection Clinical Keys - Medscape - Feb 18, 2021.