Calculators · Infectious Diseases · Score
FeverPAIN score
Also called FeverPAIN, sore throat score UK
Five-item clinical score for streptococcal sore throat used to target antibiotics (no, delayed or immediate) in primary care, age ≥3 years.
FeverPAIN
0 / 5
- PRISM trial strategy
- No antibiotic
FeverPAIN 0: the PRISM trial (UK primary care) used no antibiotic for this score. Estimated streptococcal isolation quoted in PRISM was under 20% for 0–1, about 39% for 2–3 and about 63% for 4 or more.
Formula and scoring
1 point each: Fever (24 h), Purulence, Attend rapidly (≤3 days), Inflamed tonsils, No cough/coryza. 0–1 no antibiotic, 2–3 delayed, ≥4 immediate (PRISM strategy).
Exam and ward pearls
- Using FeverPAIN to target antibiotics cut antibiotic use by 29% and slightly improved symptoms versus delayed prescribing for all (PRISM).
- Mnemonic: Fever, Purulence, Attend rapidly, Inflamed tonsils, No cough or coryza.
When not to rely on it
- Tested in UK primary care in patients aged 3 years and over with acute sore throat; not a substitute for assessment of a patient who looks systemically unwell.
Source
- Little P, Hobbs FD, Moore M, Mant D, Williamson I, McNulty C, et al. Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management). BMJ. 2013;347:f5806. doi:10.1136/bmj.f5806 · PMID 24114306
Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.