Centor Criteria (Modified)

Used to triage patients with acute sore throat to estimate probability of GAS pharyngitis and guide the need for rapid testing or culture, not to make a definitive diagnosis. Clinical utility is ruling out low‑risk patients (score 0–1) to reduce unnecessary testing/antibiotics, supported by validation data showing high specificity in children (90.3% 1 [Level I evidence]) and only fair discrimination in adults (AUC 0.6888 2 [Level II evidence]).

Start with fever, tonsillar exudate, tender anterior cervical nodes, and absence of cough; each increases probability of GAS, but predictive value varies with local prevalence, so overestimation is common in low‑prevalence primary care settings 1 [Level II evidence]. Use only to guide testing, not to diagnose. False-negative RADTs occur, and culture is useful when scores are ≥2 with high clinical concern 2 [Level II evidence].