A ten day course of oral penicillin is still recommended for pharyngotonsillitis with the aim of eradicating Streptococcus pyogenes and preventing rheumatic fever. However there is some evidence that penicillin V therapy is less satisfactory than in former years. Several explanations have been suggested, including inadequate pharmacokinetic properties, poor patient compliance, penicillin tolerance, re-infection and carrier state, and indirect pathogenicity. In this context we evaluated the efficacy of third generation cephalosporins. We have shown that a short course of five days treatment with cefpodoxime is as effective as the ten days of conventional treatment with penicillin in terms of both clinical and bacteriological efficacy. Moreover the possibility of reducing the duration of therapy and the twice daily administration of these new cephalosporins results in better patient compliance with treatment.