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. 2025 May;18(5):449-454.
doi: 10.25122/jml-2024-0397.

Physicians' knowledge and adherence to Centor Criteria for preventing acute rheumatic fever in Jeddah, Saudi Arabia

Mohammed Shaikhomer #  1 , Jumana Hussain Timraz #  2 , Nada Yasser Metwali #  2 , Fathima Shamma Bava #  2 , Zainab Yusuf #  2 , Ruqayyah Ali Ahmed #  2 , Husna Irfan Thalib  2 , Syeda Nafeesa Hashim #  2
Affiliations

Physicians' knowledge and adherence to Centor Criteria for preventing acute rheumatic fever in Jeddah, Saudi Arabia

Mohammed Shaikhomer et al. J Med Life. 2025 May.

Abstract

Acute rheumatic fever (ARF) is a delayed autoimmune complication of Group A Streptococcal (GAS) pharyngitis and remains a significant public health concern in regions such as Saudi Arabia. Timely treatment with antibiotics guided by the Centor criteria can prevent ARF, yet adherence to these recommended guidelines remains inconsistent among physicians in developing countries. This study aimed to assess the knowledge and adherence of physicians in Jeddah, Saudi Arabia, to the Centor criteria in managing streptococcal pharyngitis as a strategy to prevent ARF. A cross-sectional study was conducted among 105 physicians across various specialties. A structured questionnaire was used to evaluate their adherence and awareness. Data was analyzed using SPSS version 23.0, with chi-square tests to assess the significance (P < 0.05). Only 40% of physicians reported consistent use of the Centor criteria. Female and non-Saudi physicians demonstrated higher rates of adherence. The most compliant were consultants (42.8%), while ENT and family medicine departments demonstrated better adherence to Ministry of Health guidelines. Additionally, physicians with over 15 years of experience demonstrated significantly greater adherence than their less experienced counterparts. Significant gaps were identified in the adherence to the Centor criteria, which were influenced by professional roles and demographic factors. Promoting adherence to national guidelines and standardizing training is crucial for improving ARF prevention in Saudi Arabia.

Keywords: ACP: American College of Physicians; AHA: American Heart Association; ARF: Acute Rheumatic Fever; Acute rheumatic fever; CDC: Centre for Disease Control and Prevention; Centor criteria; GAS: Group A Streptococcus; IDSA: Infectious Diseases Society of America; MOH: Ministry of Health; RADT: Rapid Antigen Detection Test; antibiotics; streptococcal pharyngitis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Variation in the application of Centor criteria across physician subgroups
Figure 2
Figure 2
Reported use of national and international guidelines by physicians in clinical practice IDSA /ASP, Infectious Diseases Society of America / Antimicrobial Stewardship Program [11]; NICE, National Institute for Health and Care Excellence [12]; MOH, Ministry of Health [13].
Figure 3
Figure 3
Physician self-reported application of the Centor criteria in clinical practice
See this image and copyright information in PMC

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