CHAPTER 46 CENTOR CRITERIA FOR STREP THROAT

The Diagnosis of Strep Throat in Adults in the Emergency Room

Centor RM, Witherspoon JM, Dalton HP, Brody CE, Link K. Med Decis Making. 1981;1(3):239–246

BACKGROUND

Sore throat is a common ED presentation, with over 11 million cases of pharyngitis in US EDs and ambulatory clinics annually. Although Group A beta-hemolytic streptococcus (GAS) is the most common bacterial etiology of pharyngitis, the vast majority of cases are viral (80% to 95% in adults, 70% to 85% in children). Prior to this study, no simple set of criteria existed to accurately evaluate the likelihood that a patient with sore throat would have a positive culture based on history and physical examination findings, and thus there was no simple way for clinicians to predict which patients were unlikely to benefit from antibiotic treatment for GAS pharyngitis.

OBJECTIVES

To identify the prevalence of GAS in adults presenting with sore throat to an urban ED and to develop a model to determine the likelihood of bacterial pharyngitis.

METHODS

Prospective, observational study in an urban ED in 1980.

Participants

Two hundred and eighty-six consecutive patients, >15 years old, with sore throat. Select exclusion criteria: Patients whose throat cultures grew non-GAS (predominantly Groups B, C, and G). Control group was made up of 25 patients and employees aged 16 to 35 with no upper respiratory symptoms.

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