CRB-65 Score for Community-Acquired Pneumonia

Assess community-acquired pneumonia severity in primary care. CRB-65 needs no blood test.

By Dr Amer Sheikh, GP Updated 17 October 2026 Clinical review pending

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What is CRB-65?

CRB-65 is the community version of CURB-65. It drops urea, so it works without blood tests.

CRB-65 criteria

Confusion (new)
Respiratory rate 30 or more
Blood pressure: systolic below 90 or diastolic 60 or less
Age 65 or over

Interpretation

Score	Risk	NICE NG138
0	Low: under 1% mortality	Consider home care
1–2	Intermediate: 1–10%	Consider hospital assessment
3–4	High: over 10%	Urgent admission

Frequently asked questions

What is the difference between CRB-65 and CURB-65?

CURB-65 adds urea above 7 mmol/L. CRB-65 is used in the community without bloods.

What CRB-65 score needs admission?

Consider hospital assessment at 1 to 2, and urgent admission at 3 or 4.

Does CRB-65 replace clinical judgement?

No. Consider oxygen saturation, frailty and social circumstances too.

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References

NICE. Pneumonia (community-acquired): antimicrobial prescribing. NG138. nice.org.uk/guidance/ng138
Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital. Thorax 2003;58(5):377–82.

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