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 1Or 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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