What is the FeverPAIN score or Centor score for prescribing antibiotics in acute sore throat?

FeverPAIN or Centor Score

FeverPAIN or Centor Score is used to make a decision regarding starting antibiotics in case of acute sore throat. 

FeverPAIN score: Total 5 points (1 point for each)

• Fever: 1
• Purulence: 1
• Attend within 3 days or less: 1
• Severely Inflamed tonsils: 1
• No cough or coryza: 1

Centor score: Total 4 points (1 point for each)

• Tonsillar exudate: 1
• Tender anterior cervical lymphadenopathy or lymphadenitis: 1
• History of fever (>38°C): 1
• No cough: 1

Scenario 01

FeverPAIN score 0 or 1, Or Centor score 0, 1 or 2

Action: Do not offer an antibiotic 

Advice for the patient: Come back if condition worsens rapidly or significantly, no improvement after 1 week, or the patient becomes very unwell.

Scenario 02

FeverPAIN score 2 or 3

Action: Consider no antibiotic or make a back-up antibiotic prescription

Advice for the patient: No need to start antibiotic now but keep the back-up prescription. If no improvement in 3-5 days or condition worsens, start the antibiotic. Come back if condition worsen rapidly or significantly or the patient becomes very unwell

Scenario 03

FeverPAIN score 4 or 5 Or Centor score 3 or 4 

Action: Prescribe an antibiotic immediately

Advice for the patient: Come back if condition worsen rapidly or significantly or the patient becomes very unwell

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