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Centor Score (Modified)

Predict likelihood of GAS pharyngitis

Indication

  • Predict likelihood of GAS pharyngitis

Criteria

  • id: tonsillar; label: Tonsillar exudates or swelling; type: yesno; points: 1
  • id: lymph; label: Tender anterior cervical lymphadenopathy; type: yesno; points: 1
  • id: fever; label: History of fever (>38°C / 100.4°F); type: yesno; points: 1
  • id: cough; label: Absence of cough; type: yesno; points: 1
  • id: age_mod; label: Age modifier; type: options; options: label: Age 3-14; value: 1; label: Age 15-44; value: 0; label: Age ≥45; value: -1

Interpretation

  • function(score) { if (score <= 0) return { risk: score + '/5', tier: 'Very Low Risk', action: '1-2.5% probability GAS. No testing or antibiotics needed.', color: 'green' }; if (score <= 1) return { risk: score + '/5', tier: 'Low Risk', action: '5-10% probability GAS. No testing or antibiotics.', color: 'green' }; if (score <= 3) return { risk: score + '/5', tier: 'Moderate Risk', action: '11-35% probability GAS. Perform rapid strep test.', color: 'yellow' }; return { risk: score + '/5', tier: 'High Risk', action: '51-53% probability GAS. Empiric treatment or rapid strep test.', color: 'red' }; }

Clinical pearls

  • Score ≤1: no testing needed — risk of strep very low
  • Score 2-3: rapid strep test recommended
  • Score 4-5: consider empiric antibiotics or rapid strep
  • Treat confirmed GAS: Penicillin V 500mg BID x10d or Amoxicillin 500mg BID x10d

Source and review

  • Centor et al., Med Decis Making 1981; McIsaac et al., CMAJ 1998. Last reviewed: 2024-10-15