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Infection

FeverPAIN Score

Predicts Group A Streptococcal throat infection — UK guideline-endorsed alternative to Centor.

When to use: Used in primary care for sore throat assessment. Endorsed by NICE (UK) as an alternative to Centor/McIsaac for guiding antibiotic prescribing decisions. Scores 4–5 indicate high probability of GAS and justify immediate antibiotics.
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Formula
FeverPAIN = Fever + Purulence + Attend rapidly + Inflamed tonsils + No cough/coryza Each criterion = 1 point. Max = 5.
Key Points for NEET PG
  • FeverPAIN endorsed by NICE guidelines for sore throat management in primary care
  • Score 0–1: 13–18% GAS probability; 2–3: 34–40%; 4–5: 62–65%
  • Delayed prescription strategy (scores 2–3): patient fills prescription only if not improving at 2–3 days
  • Both FeverPAIN and Centor aim to reduce antibiotic overuse in sore throat — major AMR concern
  • Coryza (runny nose) suggests viral aetiology — presence argues against bacterial cause
References
Derivation and validation of the FeverPAIN score for sore throat · British Journal of General Practice (2012)
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