Analysis of Outcome of Intraplueral Streptokinase in Pediatric Empyema Thoracis even in Advanced Stages: A Prospective Study.
BACKGROUND
Empyema thoracis in children causes significant morbidity. Standard treatment of Empyema thoracis includes tube drainage and antibiotics. But the tube drainage often fails. Intrapleural Streptokinase has been used in empyema thoracis with good success rate.


OBJECTIVE
We evaluated the efficacy of intra-pleural Streptokinase in management of empyema thoracis even in advanced stages.


METHODS
A total of 28 patients with empyema thoracis requiring intercostal tube drainage aged zero to twelve years were included in the study who were admitted in Pediatric intensive care unit. 15,000 units/kg of Streptokinase was instilled into the pleural cavity. Response was assessed by clinical outcome, after unclamping and subsequent chest radiography and serial chest ultrasounds.


RESULTS
Streptokinase enhanced drainage in all patients with complete resolution of empyema thoracis in 26 patients. Two patients were referred for surgery. Only 7.2% required surgery. Streptokinase was equally effective if started before or after seven days.


CONCLUSIONS
Intrapleural Streptokinase is the preferred treatment for treating pediatric empyema thoracis even in advanced stages and can avoid surgery.
Assistant Professor, Pediatrics Chittaranjan Seva Sadan Hospital, Kolkata, India.
Kallol
K
Bose
Associate Professor, Pediatrics Chittaranjan Seva Sadan Hospital, Kolkata, India.
Sudip
S
Saha
Assistant Professor, Pediatrics Chittaranjan Seva Sadan Hospital, Kolkata, India.
Dhrubojyoti
D
Mridha
RMO cum CT, Pediatrics Chittaranjan Seva Sadan Hospital, Kolkata, India.
Kallol
K
Das
RMO cum CT, Pediatrics Chittaranjan Seva Sadan Hospital, Kolkata, India.
Piyasi
P
Mondal
RMO cum CT, Pediatrics Chittaranjan Seva Sadan Hospital, Kolkata, India.
Ira
I
Das
Empyema Thoracis; Pediatrics; Streptokinase