Yes.

Patients with a systolic blood pressure <90, a fall in the systolic of >40 mmHg from baseline or those in receipt of vasopressors should score the “B” point in CURB-65. Similarly if the urea < 7 mmol/l but the patient is receiving renal replacement therapy, or if the patient is ventilated but the respiratory rate is <30 then these would count toward the CURB-65 score.

Please only include patients who are on antibiotics and where that is a new or changed prescription within 48 hours of the day of the chest x-ray.

The screening process aims to remove patients from the work list (that is generated from the X-ray system) who are unlikely to have a lower respiratory tract infection. This is the purpose of asking about antibiotics and we would like you to exclude patients who are not on antibiotics as it seems unlikely that their clinical team are working with a possible diagnosis of pneumonia. We also recommend excluding patients where they are on antibiotics but the prescription has not changed in the 48 hours before or after the calendar day of the CXR.

This is intended to stop your needing to continue screening patients who are on antibiotics for other reasons (for example those on long term antibiotics following a splenectomy), and to avoid your screening patients where the antibiotic decision has been reversed by a more senior member of the team.