Background Antibiotic prescription for the management of all acute pharyngitis seems to be increasing recently. Streptococcal pharyngitis is the one that has strong indication for antibiotic prescription. It is quiet hard to distinguish the clinical features of streptococcal pharyngitis from non-streptococcal one. Objective To determine specifically clinical features of streptococcal pharyngitis and distinguish them from non-streptococcal one. Methods We conducted a cross-sectional study on children with acute pharyngitis at Pediatric Outpatient Department Dr. M. Djamil Hospital, Padang from November 2006 until March 2007. Data on clinical features and pharyngeal swab culture results were analyzed using chi-square test for clinical predictors. All were then reanalyzed using multivariate logistic regression. Results Ninety-five children aged 3-13 years were enrolled and pharyngeal swab culture was performed. Group A β-haemolyticus streptococcus was found in 13 children (14%). Absence of cough, sore throat, tonsillar exudates and tender anterior cervical adenopathy were the clinical predictors for streptococcal pharyngitis and the last two shared highest risk (OR 55.05; 31.82). Combination of tonsillar exudates, tender anterior cervical adenopathy and absence of cough contributed 99,3% probability. Conclusions Streptococcal pharyngitis includes a small part of all childhood with acute pharyngitis. High grade fever, sore throat, absence of cough, tonsiller excudates and tender anterior cervical adenopathy were considered as clinical predictors for childhood streptococcal pharygitis. Combination of some clinical predictors will strengthen the probability of streptococcal pharyngitis.
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