Centor Score Calculator
Score strep pharyngitis risk with modified Centor McIsaac criteria and management guidance.
What Is the Centor Score?
The Centor score (also called McIsaac when age is included) estimates the probability of group A streptococcal pharyngitis in adults and children with sore throat. It supports selective testing and antibiotic stewardship. Related tools: Amoxicillin Pediatric Dosage Calculator, Cefdinir Dose Calculator, and CAGE Questionnaire Calculator.
Scoring Criteria
- Fever above 38 °C or 100.4 °F: 1 point
- Absence of cough: 1 point
- Tonsillar exudates: 1 point
- Tender anterior cervical lymphadenopathy: 1 point
- Age under 15: +1 point; age over 45: −1 point
Management Guidance
Low scores suggest viral etiology and generally do not need culture or antibiotics. Intermediate scores warrant throat culture or rapid antigen testing before treatment. Higher scores increase strep probability and may support empiric therapy per local guidelines.
Clinical Use
Centor criteria reduce unnecessary antibiotics for pharyngitis while identifying patients who benefit from strep testing. Always consider alternative diagnoses such as peritonsillar abscess, mononucleosis, or COVID-19 when presentation is atypical.
Frequently Asked Questions
What strep probability corresponds to each score?
Published cohorts report roughly 1 to 3% at 0 points up to about 50% at scores of 4 or 5, varying by population.
Should every sore throat get a Centor score?
It is most useful in immunocompetent patients with acute pharyngitis when viral features are not dominant.
Why does age over 45 subtract a point?
Strep prevalence declines with age, so older adults with sore throat are less likely to have GAS infection.
Is rapid testing required for score 2 or 3?
Many guidelines recommend culture or rapid antigen test before antibiotics in the intermediate range.
Does Centor diagnose strep throat?
No. It estimates probability. Definitive diagnosis requires laboratory confirmation when treatment is considered.
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