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2020, Number 3

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Rev Cubana Pediatr 2020; 92 (3)

Effectiveness and security of recombinant streptokinase in children with parapneumonic pleural efussion

Loret de Mola BYÁ, Muzio GVL, Hernández-Bernal F

Language: Spanish
References: 26
Page: 1-19
PDF size: 746.13 Kb.


ABSTRACT

Introduction: The parapneumonic pleural efussion as a complication of pneumonias adquired in the community by the pediatric population represents a health problem in the world and in Cuba. The use of intrapleural fibrinolytics is a good therapeutic option.
Objective: To evaluate the effectiveness and security of the use of recombinant streptokinase in the treatment of complex parapneumonic pleural efussion in children.
Methods: Phase III confirmatory clinical trial, monocentric, open, randomized and controlled (RPCEC00000292) – named as DENIS study- carried out from September 2018 to October, 2019. There were included children (from 1 to 18 years old) that met the selection criteria including voluntariness. All of them received the established conventional treatment and were distributed in two groups: I- experimental (recombinant streptokinase, intrapleural daily dose of 200 000 UI, 3 - 5 days); II- control (conventional therapy). The main variables were need of surgery and hospital stay. There were also assessed the adverse events.
Results: 55 children with the above mentioned disease were assessed; 34 of them (61.8%) were included in the study. Any of the patients of the experimental group required surgery, opposite to the control group that required it in a 25%. The hospital stay was significantly reduced in the group that had treatment with recombinant streptokinase. There were not any severe adverse events related to the experimental treatment.
Conclusions: When recombinant streptokinase was administered in the complex parapneumonic pleural efussion resulted in an efficient and safe method for the elimination of the septic focus, with a positive impact expressed in the reduction of complications, the need of surgical treatment and the hospital stay without presenting related adverse events while using it.


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