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 take 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 worsen 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 worsen, 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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