Centor Criteria Utilization and Its Impact on Antibiotic Prescribing Practices in Pharyngo-Tonsillar Infections at a Primary Health Center – An Audit

Abstract

Pharyngo-tonsillar infections are commonly encountered in primary care settings and contribute significantly to the overuse of antibiotics, which drives the growing concern of antimicrobial resistance. The Centor Criteria, a clinical decision-making tool, is designed to assist in the accurate diagnosis of Group A Beta-Hemolytic Streptococcal (GABHS) pharyngitis and guide appropriate antibiotic use. Despite its proven effectiveness, the Centor Criteria remains underutilized in clinical practice. This audit aimed to assess the implementation of the Modified Centor Criteria at a primary health center and its impact on antibiotic prescribing practices. A retrospective analysis of 150 randomly selected patient records was conducted, focusing on documentation of the Centor Criteria, antibiotic use, and adherence to evidence-based guidelines. The results revealed that only 6.67% of cases had complete documentation of the Centor Criteria, and in non-documented cases, 75% of patients received antibiotics, with a significant preference for second-line agents. The audit highlights a critical gap in adherence to clinical guidelines and the need for better utilization of the Centor Criteria to reduce unnecessary antibiotic use and combat antimicrobial resistance. Recommendations include increased training for healthcare providers, the integration of Centor Criteria into electronic health records, and patient education on the risks of inappropriate antibiotic use.

Key words: Sore Throat,  Antibiotic Use, Centor Criteria, Bacterial Resistance