Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

Centor Score is accurate in predicting streptococcal sore throat in patients

18 April 2012
A study carried out by the HRB Centre for Primary Care Research, based in the Royal College of Surgeons in Ireland (RCSI) has completed a review of 21 validation studies of the Centor score, a clinical prediction rule used in respiratory illnesses.


The research found the Centor score has a 95% specificity rate in predicting streptococcal sore throat in patients and is a helpful predictor for healthcare professionals to assess the most appropriate prescribing for patients.


Commenting on the review, Prof Tom Fahey, Principal Investigator at the HRB Centre said ‘being able to categorise patients with a sore throat into the probability of having a bacterial or viral infection is helpful in ensuring antibiotics are only prescribed to those that need them. The incidence of antibiotic resistance is increasing which can have serious health implications and therefore it is important antibiotics are prescribed only to patients with bacterial infections to ensure the correct use of antibiotics in order to slow down resistance to these powerful drugs.'


‘From a total of 15 studies incorporating 2,900 patients, our research found the Centor score reaches 95% specificity and is a worthwhile decision aid for helping the correct prescribing for streptococcal sore throat,' Prof Fahey continued.


The Centor score is based on four clinical variables as tonsillar exudates (pus on the tonsils), tender anterior cervical adenopathy (swollen lymph nodes), absence of cough and history of fever. Based on their total number of signs and symptoms a patient is categorised into low, moderate or high risk of having streptococcal sore throat. The review found that the Centor score is useful in predicting the bacterial infection in sore throat.


The research was led by Dr Kirsty O'Brien and Dr Borislav Dimitrov from the HRB Centre for Primary Care Research. The HRB Centre is a 5-year programme funded by the Health Research Board (HRB) in Ireland.


Clinical Prediction Rules - The utility of clinical prediction rules in respiratory illnesses