CURB-65 Score 🫁
CURB-65 hospital severity score for community-acquired pneumonia. Confusion, urea, respiratory rate, blood pressure, and age ≥65 with NICE NG250 disposition guidance.
CURB-65 Severity Score
NICE NG250 hospital assessment. Tick criteria present (each scores 1 point)
CURB-65 score
0 / 5
LowNo criteria or prescribing factors ticked yet.
Low risk of death (NICE hospital CURB-65)
Consider discharge home with primary care-led services and safety-netting if clinically appropriate. Use clinical judgement for hypoxia, comorbidity, immunosuppression, or multilobar disease.
NICE NG250 regimen
Amoxicillin 500 mg three times daily for 5 days (higher doses: see BNF). Oral first line if the patient can take oral medicines.
NICE low-severity CAP (Table 1)
Prescribing factors
Tailors NICE Table 1 adult regimens. Confirm local AMS and BNF for organ impairment.
Disease severity is a clinical judgement informed by CURB-65; they often align but not always. Primary care uses CRB65 (no urea). Educational aid: confirm NICE NG250 and your Trust guideline.
Why use it
- CURB-65 estimates CAP severity in hospital. Each criterion scores 1 point (maximum 5). Urea >7 mmol/L is included.
- NICE risk bands: 0–1 low, 2 intermediate, 3–5 high. Disease severity is a clinical judgement informed by the score; they often align but not always.
- In primary care, NICE uses CRB65 (no urea). This tool is the hospital / on-call version.
Interpretation (NICE NG250)
0–1
- Risk of death
- Low
- Typical disposition
- Consider discharge home with primary care-led services and safety-netting if clinically appropriate.
2
- Risk of death
- Intermediate
- Typical disposition
- Consider virtual ward, same-day emergency care, hospital at home, or inpatient care.
3–5
- Risk of death
- High
- Typical disposition
- Consider inpatient care, with critical care referral if appropriate.
| Score | Risk of death | Typical disposition |
|---|---|---|
| 0–1 | Low | Consider discharge home with primary care-led services and safety-netting if clinically appropriate. |
| 2 | Intermediate | Consider virtual ward, same-day emergency care, hospital at home, or inpatient care. |
| 3–5 | High | Consider inpatient care, with critical care referral if appropriate. |