Between October 2006 and April 2007, we enrolled 90 children with group A streptococcal infection in a prospective multicenter study. Children aged from 8 months to 12 years (6.2 +/- 2.2 years) treated with cefditoren pivoxil 9 mg/kg/day tid for 7 days were evaluated for clinical efficacy and bacterial effect at the end of therapy and were observed for the occurrence of recurrent infection and complications 4 weeks after the end of therapy. The most frequent T-types of 90 isolates were T1, T28, and T12 at 50.0%, 21.1%, and 11.1%. Of the 90, 11 did not return for follow-up. The 79 we evaluated clinical efficacy and their symptoms were ameliorated. Four still had GAS from pharyngeal swabs at the end of therapy. Isolates from them were identical to initial strains in T-type and PFGE pattern. All 78 observed within 1 month after the end of administration had no complications, but 5 had a recurrence of GAS infection. Two still had GAS from pharyngeal swabs at the end of therapy. Isolates from recurrence cases were identical to initial strains in T-type and PFGE pattern. Adverse effects were diarrhea observed in 1.