Once-daily vs. twice-daily intrapleural urokinase treatment of complicated parapneumonic effusion in paediatric patients: A randomised, prospective study

J. N. Wang, C. T. Yao, C. N. Yeh, C. C. Liu, M. H. Wu, H. Y. Chuang, Jing Ming Wu

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11 Citations (Scopus)

Abstract

To evaluate the effective dose frequency (once daily vs. twice daily) of intrapleural urokinase treatment in children who required tube thoracostomy for drainage of a complicated parapneumonic effusion, we designed a randomised prospective study in a tertiary medical centre in Taiwan. From June 2002 to January 2005, 30 paediatric patients with complicated parapneumonic effusion who had received chest tube drainage were randomised 1:1 to the once-daily (urokinase 5000-6000IU/kg/dose) or twice-daily (urokinase 2500-3000IU/kg/dose) treatment. We compared clinical manifestations and outcomes in both groups. There were no differences in pleural effusion characteristics between the groups. Six patients had Streptococcus pneumoniae, one had Staphylococcus aureus, one had Group A Streptococcus, and 22 had unknown pathogens. There were no significant differences between the once- vs. twice-daily group in the amount of drained pleural fluid (564.9 ± 422.1ml vs. 560.5 ± 198.6ml, respectively), fever duration after chest tube insertion (4.3 ± 3.2 days vs. 5.3 ± 2.7 days), or total admission days (14.3 ± 3.9 days vs. 14.6 ± 3.0 days) (p > 0.05 for all). Only two patients (one in each group) required the surgery. Thus, we found that both once- and twice-daily administration of urokinase were similarly efficacious, and resulted in good clinical outcomes. Both obviated the need for surgery in most (93%) cases of pneumonia with complicated parapneumonic effusion in this series. A larger, multicentre study is necessary to verify our findings.

Original languageEnglish
Pages (from-to)1225-1230
Number of pages6
JournalInternational Journal of Clinical Practice
Volume60
Issue number10
DOIs
Publication statusPublished - 2006 Oct 1

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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