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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    FeverPAIN Score for Strep Pharyngitis

    Predicts likelihood of strep throat.
    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with pharyngitis in primary care settings.

    • The FeverPAIN Score for Strep Pharyngitis was developed to try and help assess which patients with pharyngitis have streptococcal infections.

    • Developed in the setting of rapid antigen detection tests for multiple streptococcal strains (Group A, C, G).

    • While it should be further validated, it appeared to have better utility than the Centor Criteria at lower levels to detect patients who could forgo antibiotic treatment (Little 2014).

    • Caution should be advised in using the FeverPAIN Score to determine need for treatment in patients that have worsening symptoms beyond 3 days. Beyond this point, the clinician must consider the possibility of a more serious or invasive infection.

    • Should not be used in children <3 years old, as they are more likely to have viral infections and/or atypical presentations of streptococcal infection.

    Identifying the minority of pharyngitis patients with streptococcal infection can help providers reduce inappropriate antibiotic use in pharyngitis. The authors that derived the FeverPAIN Score performed an implementation study suggesting it can safely reduce antibiotic use by 30% (Little 2014).

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    Next Steps
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    Creator Insights
    Dr. Paul Little

    About the Creator

    Paul Little, MD, MBBS, is a clinical professor and practicing general clinician at the University of Southampton, UK. He was the first general practitioner to be awarded a Wellcome HSR training fellowship, and the first to be awarded an MRC Clinician Scientist Fellowship. His two main areas of research are health promotion and the management of common self-limiting illnesses.

    To view Dr. Paul Little's publications, visit PubMed

    Are you Dr. Paul Little? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
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    Dr. Paul Little
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