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Centor criteria in children in a paediatric emergency department: for what it is worth

Inge Roggen1, Gerlant van Berlaer, Frans Gordts

  • 1Department of Emergency Medicine, UZ Brussel, Vrije Universiteit Brussel, Jette, Belgium.

BMJ Open
|April 25, 2013
PubMed

Insights

The Centor criteria are ineffective for diagnosing group A Streptococcus in children with sore throats. This study found no significant correlation between Centor scores and GABHS presence in pediatric patients.

Area of Science:

  • Pediatric Emergency Medicine
  • Infectious Diseases
  • Clinical Diagnostics

Background:

  • The Centor criteria, an adult-derived algorithm, assess the likelihood of group A beta-hemolytic Streptococcus (GABHS) in sore throat cases.
  • Its utility in pediatric populations for diagnosing GABHS is not well-established.

Purpose of the Study:

  • To evaluate the correlation between the Centor criteria and the presence of GABHS in children presenting with sore throat to a pediatric emergency department.
  • To determine the diagnostic accuracy of the Centor criteria in identifying GABHS in pediatric patients.

Main Methods:

  • A retrospective cohort study was conducted using medical records of children aged 2-16 years diagnosed with pharyngitis, tonsillitis, or sore throat.
  • Throat swab cultures for GABHS were analyzed. Children with specific comorbidities or prior antibiotic use were excluded.
  • Data from 441 children over a two-year period at a tertiary university hospital were analyzed.

Main Results:

  • The overall prevalence of GABHS was 32%, with higher prevalence in older children (5-16 years) compared to preschoolers (2-5 years).
  • No significant difference in GABHS prevalence was observed across different Centor scores within age groups.
  • Likelihood ratios indicated that neither individual symptoms nor a Centor score of ≥3 effectively ruled in or ruled out GABHS in children.

Conclusions:

  • The Centor criteria demonstrated ineffectiveness as a predictive factor for identifying GABHS in throat swab cultures among children.
  • Clinical assessment using Centor criteria alone is insufficient for diagnosing GABHS in pediatric sore throat cases.
Abstract

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