Pus collection within the pleural cavity (empyema) is a potentially fatal complication of pneumonia. Typically, treatment includes drainage of the infected fluid. Several small uncontrolled studies have suggested that drainage via a catheter can be improved by the intrapleural instillation of low-dose streptokinase. The first randomised controlled trial of this use of streptokinase has been published recently. We discuss the implications of this study's findings.
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