Intrapleural streptokinase for empyema and complicated parapneumonic effusions

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dc.contributor.authorDiacon A.H.
dc.contributor.authorTheron J.
dc.contributor.authorSchuurmans M.M.
dc.contributor.authorVan De Wal B.W.
dc.contributor.authorBolliger C.T.
dc.date.accessioned2011-05-15T16:15:22Z
dc.date.available2011-05-15T16:15:22Z
dc.date.issued2004
dc.description.abstractWe conducted a single-center, randomized, placebo-controlled trial to determine whether streptokinase instillations adjunctive to chest tube drainage reduce the need for surgery and improve outcome in patients with pleural empyema. Fifty-three patients (frank pus aspirated, 81%; microbiological agent cultured, 62%; mean effusion pH, 6.6 ± 0.4) received antibiotic treatment, chest tube drainage, and once-daily pleural rinses with either normal saline or normal saline with streptokinase (250,000 IU). Nine patients were excluded for various reasons before pleural rinses were started. Streptokinase (n = 22) was instilled over 4.5 ± 2 days and saline (n = 22) was instilled over 3 ± 1.3 days. One patient in each group died during treatment, Clinical treatment success and need for referral to surgery were the main outcome measures. No difference was observed after 3 days. After 7 days, streptokinase-treated patients had a higher clinical success rate (82 vs, 48%, p = 0.01) and fewer referrals for surgery (45 vs, 9%, p = 0.02). No significant radiologic or functional differences were observed between groups during follow-up over 6 months. We conclude that intrapleural streptokinase adjunctive to chest tube drainage reduces the need for surgery and improves the clinical treatment success in patients with pleural empyema.
dc.description.versionArticle
dc.identifier.citationAmerican Journal of Respiratory and Critical Care Medicine
dc.identifier.citation170
dc.identifier.citation1
dc.identifier.issn00030805
dc.identifier.urihttp://hdl.handle.net/10019.1/13308
dc.subjectplacebo
dc.subjectstreptokinase
dc.subjectfibrinolytic agent
dc.subjectsodium chloride
dc.subjectadult
dc.subjectantibiotic therapy
dc.subjectarticle
dc.subjectbacterium culture
dc.subjectclinical trial
dc.subjectcontrolled clinical trial
dc.subjectcontrolled study
dc.subjectfemale
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectnonhuman
dc.subjectoutcomes research
dc.subjectpleura effusion
dc.subjectpleura empyema
dc.subjectpriority journal
dc.subjectpus
dc.subjectrandomization
dc.subjectrandomized controlled trial
dc.subjectthorax radiography
dc.subjecttreatment outcome
dc.subjecttube
dc.subjectdrug instillation
dc.subjectlavage
dc.subjectmultimodality cancer therapy
dc.subjectwound drainage
dc.subjectAdult
dc.subjectChest Tubes
dc.subjectCombined Modality Therapy
dc.subjectDrainage
dc.subjectEmpyema, Pleural
dc.subjectFemale
dc.subjectFibrinolytic Agents
dc.subjectHumans
dc.subjectInstillation, Drug
dc.subjectIrrigation
dc.subjectMale
dc.subjectPleural Effusion
dc.subjectSodium Chloride
dc.subjectStreptokinase
dc.titleIntrapleural streptokinase for empyema and complicated parapneumonic effusions
dc.typeArticle
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