Background: Overuse of antibiotics leads to resistance. Pharyngitis is commonly viral but Group A Streptococcus (GAS) as a significant bacterial cause. GAS infections include suppurative and non-suppurative. Centor criteria assess GAS infection. McIsaac score adjusts for age, reducing antibiotic misuse.
Objectives: Assess diagnostic accuracy of McIsaac modified Centor score in predicting GABHS pharyngitis to reduce antibiotic abuse in children.
Patients and methods: Study compares modified Centor score to throat swab culture in pediatric pharyngitis. 50 patients sampled from Assiut and Qena university clinics. Inclusion: 3-14 years old, symptomatic. Exclusion: <3 or >14 years, recent antibiotics, immunocompromised, certain conditions. Throat swabs were taken from all patients for culture, analyzed for Streptococcus pyogenes. The modified Centor score was calculated based on tonsillar exudate, anterior cervical lymphadenopathy, absence of cough, fever, and age to assign points, with higher scores indicating a greater likelihood of streptococcal infection. Approved by ethics committee.
Results: 50 subjects, with 60% in preschool age and 58% male, were included. 18% positive for GABHS. The modified Centor score threshold of four showed sensitivity of 55.6% and specificity of 70.7% for diagnosing GABHS+ pharyngitis, with an area under the curve of 0.71. Swollen anterior cervical lymph nodes and temperature ≥38°C exhibited the highest sensitivity (100%, 88.9%) for GABHS+ pharyngitis, while tonsillar exudate had the highest specificity (61%).
Conclusion: Modified Centor score shows fair predictive validity, acceptable specificity. Enhances appropriate antibiotic prescribing but should be cautiously used to avoid missing GABHS+ pharyngitis and complications.