Centor criteria

Centor criteria
Centor criteria
	Streptococcus pyogenes

The Centor criteria are a set of criteria which may be used to identify the likelihood of a bacterial infection in patients complaining of a sore throat. They were developed as a method to quickly diagnose the presence of

internist at the University of Alabama at Birmingham School of Medicine

.

Criteria

The patients are judged on four criteria, with one point added for each positive criterion:[1]

Absence of cough
Tonsillar
exudates
(ooze)
History of fever
Tender anterior cervical
adenopathy

The modified Centor criteria also incorporate the patient's age:^[2]

Age under 15 add 1 point
Age over 44 subtract 1 point

Mnemonic using criteria name

A mnemonic to remember Centor is:^{[citation needed]}

C – Cough absent, or the incorrect but memorable "Can't Cough"
E – Exudate
N – Nodes
T – temperature (fever)
OR – young OR old modifier

Scoring

The point system is important in that it dictates management.

Scores may range from −1 to 5.

Guidelines for management state:^[1]

-1, 0 or 1 point(s) – No antibiotic or throat culture necessary (risk of strep. infection <10%)
2 or 3 points – Should receive a throat culture and treat with an antibiotic if culture is positive (risk of strep. infection 32% if 3 criteria, 15% if 2)
4 or 5 points – Consider rapid strep testing and or culture. (Risk of strep. infection 56%) – Infectious Diseases Society of America and American College of Physicians no longer recommend empiric treatment for strep based on symptomatology alone.

In the UK there is not a differentiator for age, and score ranges from 0 to 4, with 3–4 being offered treatment and no indication for swabs.^{[citation needed]}

The presence of all four variables indicates a 40–60%

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 strep throat than for diagnosing strep throat.^{[citation needed}

]

The Centor criteria were originally developed for adults. A study published in the British Medical Journal in 2013 looked at whether it could be applied to children aged 2–16. It was a retrospective study (2008–2010) and looked at 441 children who attended a Belgian hospital emergency department and had a throat swab taken. It concluded that the Centor criteria are ineffective in predicting the presence of Group A beta-haemolytic streptococcus (i.e. antibiotic treatment-worthy) on throat swab cultures in children.[4]