What duration of antibiotic therapy do you use for a loculated parapneumonic effusion that does not meet criteria for empyema?

It would be great to see more prospective research in this area.

I think we should be a bit more nuanced in our approach as it seems to be crude to recommend 4 to 6 weeks of IV antibiotics for every parapneumonic effusion or complicated pleural space. I think that in melding the IDSA and American As...

Empyema simply means pus in a body cavity. There are no diagnostic laboratory criteria. It is a diagnosis made based on the visual and physical characteristics of the fluid, and not laboratory findings. There are some terms that are misnomers and inappropriately use the term "empyema" (such as "spon...

Could you please clarify which criteria are missing to call it empyema?

Was the pH above 7.20 or is it not an exudate by Light's criteria?

The most appropriate medical treatment for a loculated effusion from infection (assuming it is not malignant) would be tPa/DNase with systemic antibiotics. Usin...

A total of six weeks of antibiotic therapy, including empirical anaerobic coverage if the microbiology of the pleural space infection is not definitively established, for complicated parapneumonic effusion or empyema.

The antibiotic approach is akin to that for a lung abscess.

I agree with the answers above. Empyema is poorly defined. For instance, there is no WBC count range or cut-off. The question did not state, but implied, that the effusion was drained. If drained successfully, the duration of therapy (DOT) can probably be 2 weeks. If not drained successfully, I don'...

Lots of “anecdotes,” very little data. 2 weeks, 4 weeks, 6 weeks, aerobic, anaerobic—usually based on the last 1 or 2 cases I’ve personally seen, especially if they happen to be so unusual or interesting that I remember them.

Pleural effusions are generally a response to an inflammatory process in t...