Infections: scoring tools for sore throat

Indicator type

General practice indicator for use outside the Quality and Outcomes Framework (QOF).

Although clinical decision tools are recommended by NICE guidelines, the committee noted stakeholder concerns that the current strategic direction is to divert sore throat management away from general practice settings.

Rationale

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 who might benefit from antibiotic treatment. This can help to prevent overuse of antibiotics, reduce antibiotic resistance and result in fewer side effects from antibiotics.

Source guidance

Sore throat (acute): antimicrobial prescribing. NICE guideline NG84 (2018), recommendation 1.1.3

Specification

Numerator: The number in the denominator with a recorded FeverPain or Centor score.

Denominator: The number of recorded diagnoses of sore throat in the preceding 12 months.

Calculation: Numerator divided by the denominator, multiplied by 100.

Exclusions: people who are immunosuppressed.

Definitions: Sore throat includes tonsillitis and pharyngitis.

Personalised care adjustments or exception reporting should be considered to account for situations where the patient declines or if use of a scoring tool is not appropriate.

Expected population size: An average practice with 10,000 patients would have around 328 diagnoses of sore throat per year. CPRD Aurum June 2025 (Version 2025.06.001) [Data set] Medicines and Healthcare products Regulatory Agency. Study reference: 25_005556.

To be suitable for use in comparing general practice performance there should be more than 20 diagnoses eligible for inclusion in the denominator.

ISBN: 978-1-4731-7317-0