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Randomized controlled trial of intrapleural streptokinase in empyema thoracis in children
M Singh1, J L Mathew, S Chandra
1Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. meenusingh4@rediffmail.com
Aim:
To compare intrapleural streptokinase and placebo in paediatric empyema.
Methods:
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.
Results:
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.
Conclusion:
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.
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