ebpracticenet urges you to prioritize the following organizational 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: 2017
Infectious Diseases Society of America[1]Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America (Archived). Clin Infect Dis. 2012 Nov 15;55(10):e86-102.
http://cid.oxfordjournals.org/content/55/10/e86.long
http://www.ncbi.nlm.nih.gov/pubmed/22965026?tool=bestpractice.com
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.[46]JM Miller, MJ Binnicker, S Campbell, et al. Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update by IDSA/ASM. Clinical Infectious Diseases. 2024 Mar 5.
https://www.idsociety.org/practice-guideline/laboratory-diagnosis-of-infectious-diseases/#null
Other more complex clinical scoring systems are of unproven benefit.[47]Little P, Hobbs FD, Moore M, et al; PRISM investigators. PRImary care Streptococcal Management (PRISM) study: in vitro study, diagnostic cohorts and a pragmatic adaptive randomised controlled trial with nested qualitative study and cost-effectiveness study. Health Technol Assess. 2014 Jan;18(6):vii-xxv;1-101.
https://www.journalslibrary.nihr.ac.uk/hta/hta18060#/s3
http://www.ncbi.nlm.nih.gov/pubmed/24467988?tool=bestpractice.com
McIsaac scoring system
The McIsaac scoring system, created independently, modifies the Centor algorithm to account for the increased prevalence of GAS in children.[42]McIsaac WJ, White D, Tannenbaum D, et al. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ. 1998 Jan 13;158(1):75-83.
http://www.cmaj.ca/content/158/1/75.full.pdf+html
http://www.ncbi.nlm.nih.gov/pubmed/9475915?tool=bestpractice.com
Like the Centor algorithm, a higher McIsaac composite score means greater risk of a GAS infection.