Respiratory General Medicine Emergency Medicine Strong — NICE-recommended CAP severity score for community use

CRB-65 Score for Community Pneumonia

Simplified pneumonia severity score not requiring urea measurement. Used in community and primary care settings to guide admission decisions in CAP.

Score interpretation

Low Severity — Treat at Home 0

CRB-65 = 0: Mortality < 1%. Low severity CAP.

→ Oral antibiotics at home. Amoxicillin 500mg TDS × 5 days (or doxycycline if penicillin allergy). Safety-net symptoms. Review in 48h.

Moderate Severity — Hospital Assessment 1–2

CRB-65 1–2: Mortality ~8%. Hospital assessment recommended.

→ Refer to hospital. Consider admission based on SpO₂, social factors, comorbidities. IV amoxicillin ± clarithromycin if admitted.

High Severity — Urgent Admission 3–4

CRB-65 3–4: Mortality 17–31%. Severe CAP.

→ Urgent admission. HDU/ICU if needed. IV co-amoxiclav + IV clarithromycin. Blood cultures before antibiotics. Oxygen, IV fluids, CXR.

Interpretation bands for the CRB-65. Apply clinical judgement and local guidance.

Lim WS, et al. Defining community acquired pneumonia severity on presentation to hospital. Thorax. 2003;58(5):377–382.
NICE CG191. Pneumonia (community-acquired): diagnosis and management. 2014 (updated 2019).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Same specialty

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.