FeverPAIN: acute sore throat
Stratifies acute sore throat to decide whether an antibiotic is likely to help.
When to use
Adult or child with acute sore throat where the need for an antibiotic is being discussed.
Pearls and pitfalls
- Each of the five items is worth one point, so the score runs from 0 to 5.
- The N stands for no cough or coryza, which raises the streptococcal probability.
- The score guides the antibiotic conversation; it does not replace examination or a rapid test when indicated.
- The 2 to 3 point range allows a back-up prescription, used only if symptoms do not improve within 3 to 5 days.
0 points
Unlikely to benefit
The English guideline does not offer an antibiotic in this range and advises reassessment if symptoms worsen.
Formula
FeverPAIN = fever in the past 24 hours, purulent tonsils, attendance within 3 days, severely inflamed tonsils and no cough or coryza, added together.
Evidence
Clinical score adopted by the English acute sore throat guideline, with management defined per score band.
References
- National Institute for Health and Care Excellence. Sore throat (acute): antimicrobial prescribing. NICE guideline NG84. Recommendations. https://www.nice.org.uk/guidance/ng84/chapter/Recommendations
Frequently asked questions
What is FeverPAIN: acute sore throat?
Stratifies acute sore throat to decide whether an antibiotic is likely to help. Adult or child with acute sore throat where the need for an antibiotic is being discussed.
How is the result calculated?
FeverPAIN = fever in the past 24 hours, purulent tonsils, attendance within 3 days, severely inflamed tonsils and no cough or coryza, added together.
How should the result be interpreted?
Clinical score adopted by the English acute sore throat guideline, with management defined per score band.
What are the sources?
National Institute for Health and Care Excellence. Sore throat (acute): antimicrobial prescribing. NICE guideline NG84. Recommendations.