History of fever
Tonsillar exudates
Tender anterior cervical adenopathy
Absence of cough
Modified Centor Criteria age <15 +1 age >44 -1
0 - No antibiotic or throat swab (NPV 80%)
0 or 1 - No antibiotic or throat swab (Risk of strep <10%)
2 or 3 - throat swab (Risk of strep 32% if 3 criteria, 15% if 2)
4 or 5 - empirical antibiotics (strep PPV 56%)
Centor RM, Witherspoon JM, Dalton HP, Brody CE & Link K (1981).
The diagnosis of strep throat in adults in the emergency room. Medical Decision Making: 239-246
PMID 6763125