CRB65

Each parameter scores 1: 

• Confusion (AMT≤8)

• RR >30/min

• BP systolic <90mmHg or diastolic ≤ 60mmHg

• Age ≥65. 

Score ≥3: urgent hospital admission 

Score 1-2: intermediate risk consider hospital assessment 

Score 0: low risk consider home based care 

Pregnancy/breastfeeding: Refer to hospital if CRB65 ≥1

Likely duration of symptoms: fever for 1 week, sputum production for up to 4 weeks, cough up to 6 weeks, most symptoms resolve with 3 months and may take up to 6 months to get back to normal. 

Atypical mycoplasma infection is rare in > 65 years. Failure to improve or worsening within 48 hours, consider hospital treatment or CXR. 

When life threatening infection, GP should administer antibiotics. Benzylpenicillin 1.2 gram IV or amoxicillin 1 gram orally are preferred agents

• Community Acquired Pneumonia in Children Guideline (British Thoracic Society, 2011)​

• Duration of symptoms of respiratory tract infections in children: systematic review (BMJ, 2013)

Respiratory tract infections - general

• Respiratory tract infections (NHS Choices), Chest infection - adult (CKS)​, Chest infection - adult (NHS Choices)

Pneumonia / Empyema

• Community Acquired Pneumonia in Adults Guideline (British Thoracic Society, 2009) / 

• Pneumonia in Adults: diagnosis and management (CG 191, 2014 (updated 2019).

• Pneumonia (NHS Choices), Empyema (NHS Choices)

Pneumococcal infections

• Pneumococcal infections (NHS Choices)

Legionnaire's disease: 

• Legionnaires' disease (NHS Choices)