Community Acquired Pneumonia

BTS Definition of Pneumonia

Cough and at least one other lower respiratory tract symptom AND new focal chest signs on examination AND EITHER sweating, fevers, shivers, aches and pains OR fever > 380C AND no other explanation for symptoms

Treat CAP according to clinical judgement and CURB-65 score

In all cases send sputum samples for culture and sensitivity and blood cultures if pyrexial

CURB 65 Score - 1 point for each

  • Confusion - new, Urea > 7 mmol/l, Respiratory Rate > 30 breaths per min, Systolic BP  < 90mmHg or Diastolic BP ≤ 60mmHg, Age ≥ 65 years.

Patients who have CURB-65 score 0-1 who are clinically well, have no unstable co-morbidities or social concerns should be considered for treatment in the community.

Patients who have CURB 65 score 2 who are clinically well, have no unstable co-morbidities or social concerns can be considered for treatment in the community with follow up and review.

Patients who have a CURB 65 score or 3 or more are at higher risk of death and require urgent hospital admission and treatment with IV antibiotics

NB CURB-65 score should not be used to assess the severity of any respiratory infection other than CAP.