Criteria
The patients are judged on four criteria, with one point added for each positive criterion:
- History of fever
- Tonsillar exudates
- Tender anterior cervical adenopathy
- Absence of cough
The Modified Centor Criteria add the patient's age to the criteria:
- Age <15 add 1 point
- Age >44 subtract 1 point
The point system is important in that it dictates management. Guidelines for management state:
- 0 or 1 points - No antibiotic or throat culture necessary (Risk of strep. infection <10%)
- 2 or 3 points - Should receive a throat culture and treat with an antibiotic if culture is positive (Risk of strep. infection 32% if 3 criteria, 15% if 2)
- 4 or 5 points - Treat empirically with an antibiotic (Risk of strep. infection 56%)
The presence of all four variables indicates a 40 - 60% positive predictive value for a culture of the throat to test positive for Group A Streptococcus bacteria. The absence of all four variables indicates a negative predictive value of greater than 80%. The high negative predictive value suggests that the Centor Criteria can be more effectively used for ruling out strep throat than for diagnosing strep throat.
Read more about this topic: Centor Criteria
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—V.N. (Valintin Nikolaevic)
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—Hubert H. Humphrey (1911–1978)