title: Diagnosis of acute tonsillopharyngitis in primary care: a new approach for low-resource settings.
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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Centor criteria could be safely used to reduce unnecessary antibiotic usage for tonsillopharyngitis in developing countries.
authors.affiliation: University of Uludag, Faculty of Medicine, Bursa, Turkey. zalper@uludag.edu.tr
authors.forename: Zuleyha
authors.initials: Z
authors.lastname: Alper
authors.forename: Yesim
authors.initials: Y
authors.lastname: Uncu
authors.forename: Halis
authors.initials: H
authors.lastname: Akalin
authors.forename: Ilker
authors.initials: I
authors.lastname: Ercan
authors.forename: Melda
authors.initials: M
authors.lastname: Sinirtas
authors.forename: Nazan Gonul
authors.initials: NG
authors.lastname: Bilgel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015373:Bacterial Typing Techniques / Q000191:economics; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D003363:Cost Control; D003906:Developing Countries; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D010808:Physical Examination / Q000191:economics / Q000379:methods*; D011320:Primary Health Care; D012680:Sensitivity and Specificity; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013297:Streptococcus pyogenes; D014421:Turkey; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein