OBJECTIVE： To evaluate the economical efficiency of 3 therapeutic plans for acute upper respiratory tract infection caused by group A β-hemolytic streptococcal （GAS）. METHODS： In retrospective study， 71 GAS positive patients with acute upper respiratory tract infection in our hospital during Mar. 2014-Mar. 2016 were selected and divided into group A （16 cases）， B （30 cases）， C （25 cases） according to medication method. Group A， B， C were given intramuscular injection of benzathine benzylpenicillin （1 200 000 U）， oral administration of penicillin V potassium （0.5 g， q8 h， 10 d） or oral administration of amoxicillin sulbactam （0.5 g， bid， 10 d）， respectively. Clinical efficacy and bacterial clearance were observed， and economics of 3 therapeutic plans were evaluated. RESULTS： The cure rates of 3 groups were 87.50％， 90.00％， and 92.00％； bacterial clearance rates were 88.24％， 87.87％， and 92.59％， respectively； there was no statistical significance （P＞0.05）. Cost-minimization analysis was adopted for pharmacoeconomic evaluation. The costs of 3 groups were 237.79， 279.49， 400.40 yuan， respectively. The cure rate and bacterial clearance rate of therapeutic plan C were the highest， but its cost also was the highest. The results of sensitivity analysis were consistent with the results of cost-minimization analysis. CONCLUSIONS： The intramuscular injection of benzathine benzylpenicillin can be served as first choice therapeutic plan for recurrent upper respiratory tract infection caused by GAS and patients with rhenmatic fever risk. The patients who are reluctant to be treated with penicillin but guarantee medication time can take penicillin V potassium orally. The patients with poor efficacy of common penicillin can take amoxicillin sulbactam pivoxil.