ArticlePleura and peritoneum2020
Two vs. three weeks of treatment with amoxicillin-clavulanate for stabilized community-acquired complicated parapneumonic effusions. A preliminary non-inferiority, double-blind, randomized, controlled trial.
Article in Pleura and peritoneum, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 22 citations in OpenAlex.
- Saline lavage alone prolongs drainage compared with intrapleural enzyme therapy in pleural infection: the SCOPE randomised controlled trial.The European respiratory journal · 2026Trial
- What is new in pleural infections?Breathe (Sheffield, England) · 2026Review
- The role of molecular diagnostics in pleural empyema: insights from a 4-year analysis of microbial trends and antimicrobial use.Journal of medical microbiology · 2025Article
- Patient Preferences in empYema treatment (PAPY-study): are we investigating relevant outcomes for patients?Journal of thoracic disease · 2025Article
- A Practical Approach to Pleural Infection.Pulmonary therapy · 2025Article
- Pleural Infection: Diagnosis, Management, and Future Directions.Journal of clinical medicine · 2025Review
- Clinical outcome of urgent thoracoscopic surgery on complicated parapneumonic infection with short-term preoperative antibiotic usage.Journal of thoracic disease · 2025Article
- More isn't always better: antibiotic duration after surgical decortication in pleural empyema.Journal of thoracic disease · 2024Article
- Infective Pleural Effusions-A Comprehensive Narrative Review Article.Clinics and practice · 2024Review
- Diagnosis and management of pleural infection.Breathe (Sheffield, England) · 2023Review
- Medical treatment of pleural infection: antibiotic duration and corticosteroid usefulness.Breathe (Sheffield, England) · 2023Article
- The ShortERJ open research · 2023Article
- Analysis of antibiotic use and clinical outcomes in adults with known and suspected pleural empyema.BMC infectious diseases · 2022Article
- Recent Insights into the Management of Pleural Infection.International journal of general medicine · 2021Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe optimal duration of antibiotic treatment for complicated parapneumonic effusions (CPPEs) has not been properly defined. Our aim was to compare the efficacy of amoxicillin-clavulanate for 2 vs. 3 weeks in patients with CPPE (i.e. those which required chest tube drainage).
methodsIn this non-inferiority, randomized, double-blind, controlled trial, patients with community-acquired CPPE were recruited from two centers in Spain and, after having obtained clinical stability following 2 weeks of amoxicillin-clavulanate, they were randomly assigned to placebo or antibiotic for an additional week. The primary objective was clinical success, tested for a non-inferiority margin of<10%. Secondary outcomes were the proportion of residual pleural thickening of>10 mm at 3 months, and adverse events. The study was registered with EudraCT, number 2014-003137-25. We originally planned to randomly assign 284 patients.
resultsAfter recruiting 55 patients, the study was terminated early owing to slow enrolment. A total of 25 patients were assigned to 2 weeks and 30 patients to 3 weeks of amoxicillin-clavulanate. Clinical success occurred in the 25 (100%) patients treated for 2 weeks and 29 (97%) treated for 3 weeks (difference 3%, 95% CI -3 to 9.7%). Respective between-group differences in the rate of residual pleural thickening (-12%, 95%CI -39 to 14%) and adverse events (-7%, 95%CI -16 to 2%) did not reach statistical significance.
conclusionsIn this small series of selected adult patients with community-acquired CPPE, amoxicillin-clavulanate treatment could be safely discontinued by day 14 if clinical stability was obtained.
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