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

J Chemother. 2013 Jun;25(3):148-55. doi: 10.1179/1973947813Y.0000000071.

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 = 282). 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 = 32, 11·3%), two of the criteria were observed to be positive in more than half of the cases (N = 19, 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.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacterial Typing Techniques / economics
  • Biomarkers
  • C-Reactive Protein / metabolism*
  • Child
  • Cost Control
  • Developing Countries
  • Female
  • Humans
  • Inappropriate Prescribing / prevention & control
  • Leukocyte Count*
  • Male
  • Middle Aged
  • Pharyngitis / diagnosis*
  • Pharyngitis / drug therapy
  • Pharyngitis / microbiology
  • Physical Examination / economics
  • Physical Examination / methods*
  • Primary Health Care
  • Sensitivity and Specificity
  • Streptococcal Infections / diagnosis*
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / microbiology
  • Streptococcus pyogenes*
  • Turkey
  • Young Adult

Substances

  • Biomarkers
  • C-Reactive Protein