Criteria
Your Organisational Guidance
ebpracticenet urges you to prioritise the following organisational guidance:
Acute KeelpijnPublished by: Werkgroep Ontwikkeling Richtlijnen Eerste Lijn (Worel)Last published: 2017Mal de gorge aiguPublished by: Groupe de Travail Développement de recommmandations de première ligneLast published: 2017Infectious Diseases Society of America[1]
Group A Streptococcus (GAS) pharyngitis is clinically predicted by the presence of 3 or 4 of the following (Centor criteria): pharyngeal exudate, cervical adenopathy, fever, and lack of cough. It is microbiologically confirmed by a rapid antigen test, and if negative, a throat culture for GAS.[17] Other more complex clinical scoring systems are of unproven benefit.[46]
McIsaac scoring system
The McIsaac scoring system, created independently, modifies the Centor algorithm to account for the increased prevalence of GAS in children.[41] Like the Centor algorithm, a higher McIsaac composite score means greater risk of a GAS infection.
Fever pain criteria
The FeverPAIN criteria score gives 1 point (maximum score of 5) per criteria. Higher scores suggest more severe symptoms and likely bacterial (streptococcal) cause. A score of 0 or 1 is thought to be associated with a 13 to 18% likelihood of isolating streptococcus. A score of 2 or 3 is thought to be associated with a 34 to 40% likelihood of isolating streptococcus. A score of 4 or 5 is thought to be associated with a 62 to 65% likelihood of isolating streptococcus.[42]In the UK, the Centor score and Feverpain are the two prediction rules recommended by the National Institute for Health and Care Excellence (NICE).[43]
Use of this content is subject to our disclaimer