Diagnosis of acute tonsillopharyngitis in primary care: A new approach for low-resource settings

Abstract

Background: Diagnosing GABHS (Group A-beta Hemolytic Streptococcus) tonsillopharyngitis by clinical scoring is a recommended approach in developed countries, but there is still much controversy for low resource settings.

Aim: We aimed to assess the impact of Centor criteria with the support of practical laboratory tests.

Methods: We prospectively included patients complaining sore throat (N=5282). We evaluated them in terms of Centor scoring and performed white blood cell count (WBC), C-reactive protein (CRP), rapid antigen detecting test, and throat culture.

Results: In GABHS cases (n=532, 11.3%), two of the criteria were observed to be positive in more than half of the cases (n=519, 59.3%), while 13 (40.7%) cases met three/four criteria. The specificity of having two criteria was found to be 65.5% and increased to 91.5% after including CRP and WBC.

Conclusion: Centor criteria could be safely used to reduce unnecessary antibiotic usage for tonsillopharyngitis in developing countries.