Terms used in the guideline

Terms used in the guideline

People with a sore throat caused by streptococcal bacteria are more likely to benefit from antibiotics. FeverPAIN or Centor criteria are clinical scoring tools that can help to identify the people in whom this is more likely.

FeverPAIN criteria

  • Fever (during previous 24 hours)

  • Purulence (pus on tonsils)

  • Attend rapidly (within 3 days after onset of symptoms)

  • Severely Inflamed tonsils

  • No cough or coryza (inflammation of mucus membranes in the nose)

Each of the FeverPAIN criteria score 1 point (maximum score of 5). Higher scores suggest more severe symptoms and likely bacterial (streptococcal) cause. A score of 0 or 1 is thought to be associated with a 13 to 18% likelihood of isolating streptococcus. A score of 2 or 3 is thought to be associated with a 34 to 40% likelihood of isolating streptococcus. A score of 4 or 5 is thought to be associated with a 62 to 65% likelihood of isolating streptococcus.

Centor criteria

  • Tonsillar exudate

  • Tender anterior cervical lymphadenopathy or lymphadenitis

  • History of fever (over 38°C)

  • Absence of cough

Each of the Centor criteria score 1 point (maximum score of 4). A score of 0, 1 or 2 is thought to be associated with a 3 to 17% likelihood of isolating streptococcus. A score of 3 or 4 is thought to be associated with a 32 to 56% likelihood of isolating streptococcus.

ISBN: 978-1-4731-2747-0

  • Public Health England
  • National Institute for Health and Care Excellence (NICE)