Centor Score Calculator

The centor score calculator is helps to estimates the probability of streptococcal pharyingitis in children and adults based on clinical data.

Well, before knowing about our centor criteria calculator, let’s start with some basics!

Evidence-Based Studies:

In 1981, Dr. Robert Centor found a study; the goal of the study was to develop criteria to diagnose GAS infection in adult patients who presents in the emergency department with a sore throat. The original model designated 4 centors criteria that are:

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

The patients who exhibiting all 4 variables had a 56% probability of having a group A β haemolytic Streptococcus (GABHS), patients with 3 variables had a 32% probability, patients with 2 variables had 15% probability, patients with 1 variable had 6.5% probaility, and patients with none of the variables had 2.5% probability.

Chart

In 1998, centor score was later modified to include “Age” By Dr. Warren McIsaac. However, modified centor score has been validated (McIsaac et al 2004) for use in both adults and children presenting with a sore throat. Dr. Warren McIsaac determined that using of Centor Score would helps to reduce the number of unnecessary initial antibiotic prescriptions by 48 percent, without increasing throat culture use! Also, you can readily find the mc isaac score by using the above centor criteria score calculator.

Also, the modified Centor criteria incorporate the patient’s age:

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

About Centor Criteria:

In simple terms, the centor criteria are the kind of strep throat criteria that taken into account to evaluate the probability of a streptococcal infection n adult patients complaining of a sore throat. The centor criteria for strep throat were developed to quickly diagnose the present of Group A streptococcal infection or diagnosis of streptococcal pharyngitis in patients presented to urban emergency department complaining of a sore throat. Well, try this centor score for strep pharyngitis calculator to find your strep criteria score!

Mnemonic Using Criteria Name:

Centor Stands For:

• C – Cough absent, or said to be as “Can’t Cough”
• E – Exudate
• N – Nodes
• T – temperature (fever)
• OR – young OR old modifier

About Centor score Calculator:

The centor criteria calculator evaluates whether the pharyngitis (sore throat) presented in the pateint’s can be of streptococcal cause. Apart from it, our centor score calculator makes recommendations on whether to pursue further testing or not.

How to Calculator Centor Score With This Centor Score Calculator:

Don’t fret, this strep throat score calculator is fully loaded with user-friendly interface that helps you to find your centor or strep score instantly. All you need to enter the five criteria that included in the score:

• First of all, you have to enter your age in years into the designated box
• Then, you ought to select ‘Yes’ or ‘No’ from the designated field of “Exudate or swelling on tonsils”
• Now, if cough Present, then select ‘cough’, if cough not present, then select ‘no cough’ from the drop-down menu
• Then, you have to choose ‘Yes’ or ‘No’ form the designated field of Tender/Swollen anterior cervical lymph nodes
• Then, you have to enter your current body temperature in to the designated field, but before the select whether you want to enter you temperature in ‘°C’ or ‘°F’
• Once done, hit the calculate button, the Centor Score Calculator shows your centor score and shows further recommendations according to your clinical data

Elaboration on Scoring Method:

Pharyngitis (sore throat) is said to be common presentation that can be caused by different factors, including a streptococcal agent, this usually cause in young children.

The strep throat score facilitates the first stage of diagnosis and also offer recommendation to clinicians as to whether further diagnosis (strep culture) should be pursued. Our centor scoring calculator works efficiently to find this score!

The five centor criteria included in the score are as follow:

• Patient age – with only three age groups that indicates the low probability of GAS in children younger than 3 and in the elderly
• Exudate or swelling on tonsils
• Tender/Swollen anterior cervical lymph nodes
• Fever more than 38C, 100.4F
• Cough present

Remember that the presence of three or four of the clinical signs indicates for further diagnosis of Group A beta-haemolytic streptococcus (GABHS) just cause of presentation with a sore throat – and patient with a 40-60% require antibiotic treatment.

Also, the absence of the clinical signs referred to as a negative diagnosis in 80% of cases, that’s the reason why there is no need for antibiotic therapy.

According to the National Institute for Health and Clinical Excellence (NICE), antibiotic therapy in all cases with positive culture results and also Centor score that higher than 3.

However, the criticism got by the centor score is that it provides false negatives when the symptoms are mild or not exacerbated, thus, there is need to preventing patients from being given appropriate/acutal therapy at the right time.

Result Interpretation:

In fact, all the five centaur criteria will show a different weight in the final score. However, there are three age categories:

• 3 to 14 (1 point);
• 15 to 44 (0 points);
• 45 and above (-1 point).

As streptococcal pharyingitis is said to be a condition with predisposition to affect children and young adults. And, the patients who are over 45 are considered highly unlikely to develop it, thus the (-1) weight.

However, the other 4 centor criteria are risk factors for positive diagnosis thus they awarded 1 point if present.

Keep in mind, the centor score varies from -1 to 5.The probability of positive group A β haemolytic Streptococcus (GABHS) diagnosis is elaborated in the given table:

Table:

Did You Know?

If the Rapid Strep test is positive, then the antibiotic and supportive therapy suggestions are given below:

• Penicillin V Potassium 250 mg Tab
• Azithromycin 250 mg Tab
• Amoxicillin 875 mg Tab
• Cephalexin 500 mg Tab

If the Rapid Strep test is negative, then supportive therapy suggestions are given below:

• Acetaminophen ER 650 mg Tab
• Benzocaine-Menthol 6 mg-10 mg Lozenges
• Ibuprofen 400 MG Tab

Note: Before taking one of the above medicines, you should have to consult with your MEDICAL EXPERT!

Frequently Ask Questions:

What is the modified Centor score?

The Modified Centor Score is also said to be as McIssac Score or the McIssac Modification of the Centor Score) that helps to predict the probability of streptococcal pharyngitis by taking into account risk factors:

• Patient’s age
• Symptoms
• Physical Exam

Which antibiotics treat pharyngitis?

Penicillin or amoxicillin is a well-known antibiotic to treat group A strep pharyngitis. There was no report of the clinical isolate of group A strep, which is resistant to penicillin. However, resistance to clarithromycin and azithromycin is common in some communities.

What is strep A?

Group A streptococcus is a bacterium, which usually found in the throat and on the skin. In fact, individuals may carry group A streptococci in the throat or on the skin and even have no symptoms of illness. Experts reveal that most GAS infections are relatively mild illness like strep throat or impetigo.

How did I get pharyngitis?

Pharyngitis is something that is caused by swelling in the back of the throat (pharynx) between the tonsils and the voice box (larynx). Studies reported that most sore throats are caused by cold, the flu, coxsackie virus or mono (mononucleosis). Strep throat is caused by group A streptococcus (GABHS).

Does strep stay in your body forever?

Experts depict that strep will go away on its own. However, human body’s immune system can & will eventually clear the strep bacteria.

Disclaimer:

The centor score calculator is intended for information/educational purposes only, the authors make no claims of the accuracy of the information contained herein. So, for further query regarding centor criteria, you should have to consult to MEDICAL PRO!

References:

BETH A. CHOBY, MD, University of Tennessee College of Medicine–Chattanooga, Chattanooga, Tennessee – Am Fam Physician. 2009 Mar 1;79(5):383-390 – Diagnosis and Treatment of Streptococcal Pharyngitis

Centers for Disease Control and Prevention – CDC – Group A Strep Home – For Clinicians – Group A Streptococcal (GAS) Disease

Clinical Infectious Diseases, Volume 35, Issue 2, 15 July 2002, Pages 126–129, (successfully Published) – Diagnosis of Strep Throat in Adults

National Institute for Health and Care Excellence – Sore throat (acute): antimicrobial prescribing
NICE guideline [NG84] – Terms used in the guideline – FeverPAIN criteria And Centor criteria