ROUNDS·
Respiratory / ID

Pneumonia Management: CURB-65 Explained

How CURB-65 guides the outpatient-vs-admission decision, plus a quick overview of antibiotic approach by severity.

Classifying Pneumonia

Community-acquired pneumonia (CAP) is distinguished from hospital-acquired pneumonia (HAP, onset 48 hours or more after admission) and ventilator-associated pneumonia (VAP) — the distinction matters because expected pathogens and resistance patterns differ.

When to Admit — CURB-65

The CURB-65 score sums five one-point criteria (confusion, urea, respiratory rate, blood pressure, age 65+):

Antibiotics Basics by Severity

Always follow local antimicrobial guidelines — resistance patterns vary by region. See the Common Antibiotics Guide for an overview of drug classes.

Severity Beyond the Score

CURB-65 doesn't capture oxygen saturation, significant comorbidities, or the ability to manage safely at home — any of these can independently justify admission even with a low score.

Frequently Asked Questions

Is CURB-65 used for hospital-acquired pneumonia too?

No — it was derived and validated specifically for community-acquired pneumonia. HAP/VAP severity and treatment follow separate pathways.

What's the simplified version for primary care?

CRB-65 drops the urea criterion (no blood test needed), useful where labs aren't immediately available.

Does a CURB-65 of 0 mean no follow-up is needed?

It means outpatient treatment is often reasonable, but follow-up to confirm clinical improvement is still standard practice.