There is no justification to maintain a systematic antibiotic treatment of all tonsillitis as currently practiced in France. Indeed, it is today possible to exclude the streptococcal origin of tonsillitis with a fair probability using a rapid diagnosis test. It is therefore mandatory that these tests are made available to the French practitioner. Additionally, alternatives to the classical 10-day penicillin V treatment of streptococcal tonsillitis must be seriously considered: shorter duration treatment with oral cephalosporins, macrolides or amoxicillin have proved to be as efficient and of lower cost; they are also probably safer due to a better compliance related to the shorter duration.