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The Infectious Diseases Society of America (IDSA) has released new guidelines for diagnosing strep throat, recommending the use of scoring systems to help determine which patients should be tested for group A streptococcal pharyngitis.
According to the guidelines, evidence indicates that two main scoring systems slightly outperform clinical judgment in diagnosing strep throat and can help guide appropriate patient treatment.
The Centor tool assigns one point for each of the following symptoms: tonsillar swelling, lymph node swelling, fever, and absence of cough. The McIsaac system considers a person’s age, adding a point for patients 3-14 years of age and subtracting a point for those over the age of 45 years.
Scores of 0-1 indicate low likelihood of strep throat, meaning testing is not recommended. A score of 2 requires testing before treatment. Scores of 3-5 suggest either immediate testing or empiric treatment. High-risk patients should be considered for testing, even if scores are low.
This approach helps support clinicians in reducing testing for low-risk patients to minimize false positives, overdiagnosis, and unnecessary antibiotic use.
This content was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
