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Due to lack of \u03b2-lactamase enzyme production, it was considered universally susceptible to penicillin group and later generation of \u03b2-lactam antibiotics. As such, empirical treatment was common which might leads to development of antibiotics resistance. Therefore, the aims of this study were to determine the prevalence, antibiotics susceptibility profile; and associated factors of\n                      <jats:italic>S. pyogenes<\/jats:italic>\n                      among pediatric patients with acute pharyngitis in Felege Hiwot Comprehensive Specialized Hospital (FHCSH), Northwest Ethiopia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Hospital based cross-sectional study was carried out on 154 pediatric patients, whose age ranged from 0 to 18 years old using consecutive convenient sampling technique from 1st February to 19th June 2020 at FHCSH.\n                      <jats:italic>S. pyogenes<\/jats:italic>\n                      were identified by throat swab culture on 5% sheep blood agar with an overnight incubation at 37 \u00b0C in candle jar containing 5% CO\n                      <jats:sub>2<\/jats:sub>\n                      . Gram stain, catalase test and bacitracin test were used to identify\n                      <jats:italic>S. pyogenes<\/jats:italic>\n                      . Then,the data were entered into EpiData version 3.1 and analyzed by SPSS version 20 software. Finally, stepwise,\u00a0bivariable and multivariable logistic regressions were carried out for identifyying factors having significant ssociation (p&lt;0.05)\u00a0with\u00a0 acute\u00a0pharyngitis.\u00a0\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From the total throat swabs, 14 (9.1%) with (95% CI; 4.5\u201314.3) were culture positive for\n                      <jats:italic>S. pyogenes.<\/jats:italic>\n                      From these, all isolates were sensitive to penicillin and ampicillin. On the otherhand, 4 (35.7%), 4 (35.5%), 3 (21.4%), 2 (14.3%), 1 (7.1%), 7 (50.0%) and 1 (7.1%) isolates\u00a0were resistant for ceftriaxone, vancomycin, erythromycin, tetracycline, chloramphenicol, clindamycin and levofloxacin, respectively. The presence of any smoker in home showed significant association with\n                      <jats:italic>S. pyogenes<\/jats:italic>\n                      acute pharyngitis. Furthermore, having tender lymphadenopathy and recurrence were clinical predictors for\n                      <jats:italic>S. pyogenes<\/jats:italic>\n                      acute pharyngitis (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The prevalence of\n                      <jats:italic>S. pyogenes<\/jats:italic>\n                      was guaged at\u00a09.1% which is considered as low prevalence. All\n                      <jats:italic>S. pyogenes<\/jats:italic>\n                      isolats\u00a0remain sensitive to penicillin. However, resistance was reported to clindamycin 7 (50.0%), ceftriaxone 5 (35.7%) and erythromycin 3 (21.4%). The current practice of giving erythromycin, clindamycin instead of penicillin and ampicillin is againest the microbiology result. Therefore, current empirical treatment of acute pharyngitis shall take in to account the current evidences. Continuous surveillance of antibiotics resistance pattern of\n                      <jats:italic>S. pyogenes<\/jats:italic>\n                      for acute pharyngitis must be strengthen to improve the use of antibiotics in hospitals.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12866-021-02196-0","type":"journal-article","created":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T06:03:10Z","timestamp":1620021790000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Prevalence and antibiotics susceptibility profiles of Streptococcus pyogenes among pediatric patients with acute pharyngitis at Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia"],"prefix":"10.1186","volume":"21","author":[{"given":"Destaw","family":"Kebede","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alemale","family":"Admas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mekonnen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,3]]},"reference":[{"issue":"2","key":"2196_CR1","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1128\/CMR.00101-13","volume":"27","author":"MJ Walker","year":"2014","unstructured":"Walker MJ, Barnett TC, McArthur JD, Cole JN, Gillen CM, Henningham A, et al. 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Additionally, informed written consents from guardians or parents and assents from each study participants were obtained in accordance with the Declaration of Helsinki. The confidentiality of study participant was kept and identification of study participant by name was avoided. Positive individuals were linked to health institution for better managements accordingly.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"135"}}