Talk:Pleural empyema

message: A pyothorax is a form of empyema, but an empyema is not necessarily a pyothorax - it can be an appendicitis, a pyometra, a septic arthritis etc. Please stop using "empyema" as a synonym for pyothorax - medically spoken, this is wrong. --69.91.167.69 (talk) 18:32, 30 July 2008 (UTC)
thread_title:  Empyema and Pyothorax 

message: Ah, thrombolytics in empyema: a can of worms indeed. :-)
If I recall correctly, the MIST (MRC trial) data hasn't been published yet. In any case, the Cochrane database states: -
:"The numbers of patients in the controlled trials are small. In meta-analysis of these trials, intrapleural fibrinolytic therapy confers significant benefit when compared with normal saline control. Although lesser levels of evidence suggest that intrapleural fibrinolysis can be considered as an important adjunctive therapy to intercostal tube drainage in these conditions, on the basis of RCT evidence alone, we cannot recommend the routine use of fibrinolysis in their management as the trial numbers are too small."
I deliberately didn't include thrombolytics in the article because the evidence still isn't clear-cut (although if you can find the MIST data I would be very interested). Axl 23:47, 8 Nov 2004 (UTC)
replies: text: See, this is why we need you around. I just stuffed into the article something that I'd heard about... :-) JFW | T@lk 23:35, 9 Nov 2004 (UTC)
thread_title:  Thrombolytics 

message: seems useful and comprehensive. JFW | T@lk 12:20, 12 August 2010 (UTC)
replies: text: As does doi:10.1183/09059180.00005610 JFW | T@lk 04:31, 26 November 2010 (UTC)

text: New BTS guidelines. doi:10.1136/thx.2010.137000. JFW | T@lk 12:22, 4 May 2011 (UTC)
thread_title:  Source 

message: I removed the following text from the article:-
 "Pleural empyema is also seen in severe cases of amoebiasis where the entamoeba reaches the pleural cavity either by direct{through blood - rare} or primarily from liver to lung[plerual cavity]."
No reference was supplied. The only secondary source that I found was this one. However that source is inappropriate because it is explicitly about thoracic amoebiasis, not a general discussion of empyema. The only other source that I found was this case report. Axl ¤ [Talk] 08:23, 31 July 2013 (UTC)
thread_title:  Amoeba 

message: I have removed the following text from the article:-
"Aminoglycosides should be avoided as they have poor penetration into the pleural space (This sentence contradicts the previous one where it says clindamycin, vancomycin, gentamycin (which are aminoglycosides) should be used)."
Clindamycin and vancomycin are not aminoglycosides. I shall review the current literature regarding gentamicin/aminoglycosides. Axl ¤ [Talk] 01:23, 20 January 2016 (UTC)
replies: text: From Light's Pleural Diseases (6th edition, 2013), chapter 12, page 225: "The degree to which the different antibiotics penetrated the infected pleural space was highly variable. Metronidazole penetrated most easily, followed by penicillin, clindamycin, vancomycin, ceftriaxone, and gentamicin. Subsequent studies demonstrated that the quinolones, clarithromycin, azithromycin, linezolid, and ertapenem penetrate the infected pleural space well. This variance in the penetrance of antibiotics into the pleural fluid should be considered when an antibiotic is selected for the treatment of patients with parapneumonic effusions." Axl ¤ [Talk] 01:40, 20 January 2016 (UTC)
thread_title:  Aminoglycosides