Randomized controlled trial of intrapleural streptokinase in empyema thoracis in children.
To compare intrapleural streptokinase and placebo in paediatric empyema.



Children with empyema greater than stage 5 received intrapleural streptokinase (n = 19) or normal saline (n = 21) along with intercostal drainage. Clinical and serial sonographic outcomes were compared.



Although there was no difference in clinical and sonographic outcome, none of the children with stage 7 empyema (multi-loculated empyema) who received streptokinase developed pleural thickening 30 d later.



There is no short-term clinical benefit of intrapleural streptokinase in paediatric empyema; this therapy may be reserved for those with stage 7 empyema to prevent pleural thickening in the long term.
Singh
M
M
Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. meenusingh4@rediffmail.com
Mathew
J L
JL
Chandra
S
S
Katariya
S
S
Kumar
L
L
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004322:Drainage; D016724:Empyema, Pleural / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D036502:Infusions, Intralesional; D008297:Male; D011446:Prospective Studies; D013300:Streptokinase / Q000008:administration & dosage / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D005343:Fibrinolytic Agents; D013300:Streptokinase