Pleural infection refers to an accumulation of infected fluid in the space between the ribs and lungs. The condition, usually the result of lung infections such aspneumonia, can cause breathing problems as the infected fluid puts pressure on the lungs.
Current standard treatment includes antibiotics and insertion of a tube into the chest to drain the fluid, but this approach fails in about one-third of cases. Surgery is another option, but may not be suitable for older or sicker patients.
In a clinical trial involving 210 patients, researchers at the University of Oxford found that a combination oftissue plasminogen activator (tPA) and DNase helped to drain infected fluid from the chest, reduce fever, decrease the need for surgery, and shorten hospital stays.
A week of treatment with the two drugs led to a 30 percent reduction in the amount of fluid in the chest, compared to 17 percent for patients who received a placebo.
"This is an exciting result because this combination of two drugs has not been tested before for this condition," first author Dr. Najib Rahman, of the Oxford Respiratory Trials Unit, said in a university news release. "While neither drug appears to work on its own, the combination therapy very significantly improves the drainage of the infected fluid."
The study was published in the Aug. 11 issue of the New England Journal of Medicine.
Cost of the two-drug treatment would be about $1,600, but savings from shorter hospital stays could offset the expense, the researchers said. However, the combination therapy should be reserved for patients who haven't responded to conventional treatments or who are too frail for surgery, they added