CURB-65 Score for Pneumonia
Estimates 30-day mortality risk and guides admission decisions in community-acquired pneumonia
How to use & interpret
CURB-65 grades community-acquired pneumonia severity to guide where a patient is managed. One point each for Confusion, Urea >7 mmol/L, Respiratory rate ≥30, Blood pressure (systolic <90 or diastolic ≤60), and age ≥65.
A score of 0–1 is generally suitable for home/outpatient treatment, 2 for consideration of short-stay or supervised hospital care, and 3–5 for hospital management with assessment for higher-level care. Always combine the score with clinical judgement, oxygenation, comorbidities and social circumstances; CRB-65 (without urea) can be used in primary care.
Score interpretation
CURB-65 0–1: 1.5% 30-day mortality
→ Consider home treatment with oral antibiotics and close follow-up
CURB-65 2: 9.2% 30-day mortality
→ Hospital admission; IV antibiotics
CURB-65 3–5: 22% 30-day mortality
→ Urgent hospital admission; consider HDU/ICU; IV antibiotics
Interpretation bands for the CURB-65. Apply clinical judgement and local guidance.
Frequently asked questions
What is the difference between CURB-65 and CRB-65?
CRB-65 omits the urea (blood test) component, so it can be used in the community without bloods. CURB-65 is used where a urea result is available, typically in hospital.
References
- Lim WS, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58(5):377–82.
Related
Curated clinical cross-links plus same-class fallbacks.
- Doxapram hydrochloride · Respiratory stimulant
- Cefuroxime · Second-Generation Cephalosporin — Respiratory / Surgical Prophylaxis
- Clarithromycin · Macrolide Antibiotic — Respiratory / H. pylori / MAC
- Lefamulin · Pleuromutilin Antibiotic (Community-Acquired Pneumonia)
- Respiratory syncytial virus (RSV) vaccine · RSV pre-fusion F protein vaccine
- Ceftriaxone (Paediatric) · Third-Generation Cephalosporin — Meningitis / Sepsis / Community-Acquired Pneumonia
Featured in these MRCEM clinical pathways
The CURB-65 is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.