CURB-65 Score

Predicts 30-day mortality in community-acquired pneumonia (CAP) and guides the locus of care (outpatient vs inpatient vs ICU) and empirical antibiotic selection.

Confusion +1

AMTS ≤ 8 or new disorientation in person, place, or time

Urea +1

Blood Urea Nitrogen (BUN) > 19 mg/dL or Urea > 7 mmol/L

Respiratory Rate +1

≥ 30 breaths per minute

Blood Pressure +1

Systolic < 90 mmHg OR Diastolic ≤ 60 mmHg

Age ≥ 65 years +1

Total Score

/ 5

NICE / BTS Guidelines

Score 0-1: Low Severity
Mortality < 3%. Suitable for home treatment (oral Amoxicillin usually first-line).
Score 2: Moderate Severity
Mortality ~9%. Consider short-stay hospital admission or hospital-at-home. Dual oral therapy (e.g., Amoxicillin + Macrolide).
Score 3-5: High Severity
Mortality 15-40%. Urgent hospital admission required, consider ICU if score ≥ 4. IV antibiotics (e.g., Co-amoxiclav + Clarithromycin).

Note: CRB-65 (excluding Urea) can be used in primary care where immediate blood results are unavailable. A CRB-65 of 0 is low risk.

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