Management

The decision to admit a patient should be based on clinical judgment with consideration of age, severity of illness, co-morbid conditions, and factors that may compromise the safety of home care.

The nonresponding patient should be evaluated for noninfectious mimics of pneumonia, unsuspected or drug-resistant organisms, extrapulmonary sites of infection, and complications of pneumonia and its therapy. If a noninfectious etiology is identified, antibiotics should be discontinued.

A CURB-65 score may be calculated to assist in patient disposition decisions.

If BUN level is unavailable, the CRB-65 score can be calculated instead and appears to perform comparably to CURB-65 score.

Online calculators of CURB-65 and CRB-65 are widely available through Google.