Saying that sore throats are simple has become a trope, as thus many physicians do not seem to have a thoughtful approach to adolescent/young adult pharyngitis.  As the author of the Centor Score, I would like you to consider these points when seeing sore throat patients.

  1. The most important use of the score involves identifying those who need neither diagnostic tests nor antibiotics.  Too many urgent cares run a group A rapid strep test on everyone with a sore throat.
  2. The score is meant for acute (3 day or less) sore throat symptoms.
  3. The score stratifies adolescent/young adults with bacterial pharyngitis – group A strep, group C/G strep and fusobacterium necrophorum
  4. Sore throat improve over 3-5 days, if a sore throat is worsening, the patient deserves further consideration.  This case report we published could help –
  5. Pre-adolescents have differing severity and rarely have infections with bacteria other than GAS.

Most sore throats are simple.  Our job is to recognize when the patient does not fit the usual illness script


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