WardRound

For healthcare professionals. Educational tool only — not a medical device. Verify all results against the current BNF, NICE guidance and local policy, and apply clinical judgement.

Risk scoresRespiratory

CURB-65 — pneumonia severity

Stratifies severity of community-acquired pneumonia to guide site-of-care and antibiotic decisions (NICE NG250).

CURB-65 score

0

Low risk — consider ambulatory/home treatment

30-day mortality (derivation cohort)
0.6%

Caveats & limitations

  • A severity aid, not a rule — clinical judgement, social factors, oxygenation and comorbidity also drive admission decisions.
  • Mortality figures are from the derivation cohorts; absolute rates vary by setting and era.
  • Does not apply to hospital-acquired pneumonia or children.

Evidence & UK guidance

Primary evidence

  • Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58(5):377–382.

    PubMedDOI

UK practice

NICE NG250 recommends CURB-65 in hospital (CRB65 in the community) to stratify CAP severity: low severity (0–1) is suitable for home treatment with oral amoxicillin; moderate (2) and high (3–5) severity drive admission and broader antibiotic choices.

Official resources

Formula and citations last verified: 2026-08-03

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The Royal College of Physicians' aggregate score for detecting deterioration in acutely ill adults — the NHS standard.

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