Summary Of Sore Throat And Strep Throat Post, Enter The Centor, From Taming The SRU

In this post, I link to and excerpt from Enter The Centor, [about sore throat and strep throat] by Taming The SRU, September 08, 2019.

All that follows is from the above resource.

QUICK HITS [Summary of the post]

  • When evaluating a patient with sore throat, consider alternatives to group A streptococcal pharyngitis. Mimics include acute HIV, gonococcal pharyngitis, and infectious mononucleosis.

  • The modified Centor score uses 5 factors to help guide clinical decision making:

    • Fever

    • Tonsillar exudate

    • Absent cough

    • Anterior cervical lymphadenopathy

    • Age

  • Low modified Centor scores do not require further testing or treatment in the general population

  • Mid range Centor scores require rapid antigen detection testing (RADT)

  • High modified Centor scores can undergo RADT or empiric treatment according to some guidelines, however, there is concern that empiric treatment may lead to antibiotic overuse.

  • Treatment with penicillin V or amoxicillin is preferred, in the penicillin allergic patient, first generation cephalosporins or a macrolide can be used.

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