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Infection

Centor Score (Modified McIsaac)

Predicts likelihood of Group A Streptococcal pharyngitis — guides antibiotic use.

When to use: Used in patients presenting with sore throat to estimate probability of Group A Streptococcus (GAS) and guide decision to test or treat empirically. Reduces unnecessary antibiotic prescribing.
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Formula
Centor = Exudate (+1) + Tender anterior nodes (+1) + Fever (+1) + No cough (+1) + Age mod McIsaac modification adds age: 3–14 (+1), 15–44 (0), ≥45 (−1)
Key Points for NEET PG
  • Original Centor score (4 items) used in adults; McIsaac added age modifier for paediatric use
  • GAS pharyngitis treatment: Penicillin V (first choice) or Amoxicillin for 10 days
  • Penicillin allergy: Azithromycin or first-generation cephalosporin
  • Untreated GAS: risk of rheumatic fever — more common in developing countries including India
  • Viral pharyngitis (most common) does NOT benefit from antibiotics — FeverPAIN or Centor guides this
References
A clinical score to reduce unnecessary antibiotic use in patients with sore throat · CMAJ (1998)
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