INTRODUCTION: Centor criteria (fever >38.5°C, swollen, tender anterior cervical 
lymph nodes, tonsillar exudate and absence of cough) are an algorithm to assess 
the probability of group A β haemolytic Streptococcus (GABHS) as the origin of 
sore throat, developed for adults. We wanted to evaluate the correlation between 
Centor criteria and presence of GABHS in children with sore throat admitted to 
our paediatric emergency department (PED).
DESIGN: Retrospective cohort study.
SETTING: The emergency department of a large tertiary university hospital in 
Brussels, with over 20 000 yearly visits for children below age 16.
PARTICIPANTS: All medical records (from 2008 to 2010) of children between ages 2 
and 16, who were diagnosed with pharyngitis, tonsillitis or sore throat and 
having a throat swab culture for GABHS. Children with underlying chronic 
respiratory, cardiac, haematological or immunological diseases and children who 
had already received antibiotics (AB) prior to the PED consult were excluded. 
Only records with a full disease history were selected. Out of a total 2118 
visits for sore throats, 441 met our criteria. The children were divided into 
two age groups, 2-5 and 5-16 years.
RESULTS: The prevalence of GABHS was higher in the older children compared to 
the preschoolers (38.7 vs 27.6; p=0.01), and the overall prevalence was 32%. 
There was no significant difference in the prevalence of GABHS for all different 
Centor scores within an age group. Likelihood ratios (LR) demonstrate that none 
of the individual symptoms or a Centor score of ≥3 seems to be effective in 
ruling in or ruling out GABHS. Pooled LR (CI) for Centor ≥3 was 0.67 (CI 0.50 to 
0.90) for the preschoolers and 1.37 (CI 1.04 to 1.79) for the older children.
CONCLUSIONS: Our results confirm the ineffectiveness of Centor criteria as a 
predicting factor for finding GABHS in a throat swab culture in children.