Friday 22 November 2024
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| Clinical Calculators - Centor Criteria (Modified) | ||
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The Centor Criteria1 are a set of criteria which may be used to identify the likelihood of a bacterial infection in adult patients complaining of a sore throat. They were developed as a method to quickly diagnose the presence of Group A streptococcal infection or a diagnosis of Streptococcal Pharyngitis in "adult patients who presented to an urban emergency room complaining of a sore throat." The Modified Centor Criteria2 takes account of the patient's age. You must give information about all five assessments - fever, tonsillar exudate, tender anterior cervical adenopathy, cough and age - in order to determine a Centor score for this patient. |
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The presence of all four variables indicates a 40 - 60% positive predictive value for a culture of the throat to test positive for Group A Streptococcus bacteria. The absence of all four variables indicates a negative predictive value of greater than 80%3. The high negative predictive value suggests that the Centor Criteria can be more effectively used for ruling out streptococcal throat infection than for diagnosing streptococcal throat infection. Antibiotics: Phenoxymethylpenicillin remains first line due to its high effectiveness, no reported resistance, and narrow spectrum of activity. In the event of non-availability, amoxicillin, macrolides and cefalexin are alternative agents in decreasing preference. Antibiotic treatment length for sore throat should follow NICE guidance. For phenoxymethylpenicillin: Five days of phenoxymethylpenicillin may be enough for symptomatic cure, but a 10-day course may increase the chance of microbiological cure See also the FeverPAIN Score |
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