Centor Score (modified by McIsaac)

The Centor score was developed to predict the probability of a positive culture for group A β-hemolytic streptococci in patients with pharyngitis. The modification by McIsaac et al. also takes the patient’s age into account. The score can only be applied to acute pharyngitis within the first three days and is only valid for patients ≥ 3 years.

years
Temperature ≥ 38 °C
Cough
Swollen, tender anterior cervical nodes
Tonsillar swelling or exudate

(modified by McIsaac)

Interpretation
Score Probability of group A β-hemolytic streptococci Recommendation
≤ 0 1-2.5 % No further diagnostics or antibiotic therapy recommended
1 5-10 %
2 11-17 % Perform culture/rapid test, antibiotic therapy recommended if positive
3 28-35 %
≥ 4 51-53 % Empirical antibiotic therapy recommended
References
  1. Centor RM, Witherspoon JM, Dalton HP et al. The diagnosis of strep throat in adults in the emergency room. Med Decis Making 1981; 1: 239-246
  2. McIsaac WJ, White D, Tannenbaum D et al. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ 1998; 158: 75-83
  3. McIsaac WJ, Kellner JD, Aufricht P et al. Empirical validation of guidelines for the management of pharyngitis in children and adults. JAMA 2004; 291: 1587-1595

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