IDSA 2019 guidelines recommend clinical judgement plus PSI over CURB-65. 
Risk Factors
Classification
Classes I and II: consider discharge
Class III: discharge verus admit based on clinical judgment
Classes IV and V: consider admission
Approximate 30-day mortalities and Tx considerations
+1 --> 3%, outpt tx
+2 -->7%, inpt, possible outpt
+3 --> 14% inpt, possible ICU
+4-5 --> 30% ICU
+1 --> 3%, outpt tx
+2 -->7%, inpt, possible outpt
+3 --> 14% inpt, possible ICU
+4-5 --> 30% ICU
Pneumonia 
Pulmonary
Pleuritis
Airway obstruction
Atypical pneumonia
Anaphylaxis
Lung abscess
Angioedema