BTS guidelines for the management of pleural infection

There is great variation worldwide in the man-agement of patients with pleural infection,and approaches differ between physicians.1–14 In the UK up to 40 % of empyema patients come to surgery due to failed catheter drainage4 and, over-all, 20 % of patients with empyema die.4 The proc-ess of rapid evaluation and therapeutic interven-tion appears to reduce morbidity and mortality, as well as health care costs. This paper presents the results of a peer reviewed systematic literature review, combined with expert opinion, of the preferred manage-ment of pleural infection. The clinical guidelines generated from this process are shown in fig 1. The guidelines are aimed predominantly at physi-cians involved in general and respiratory medi-cine, and specifically do not cover in detail the complex areas of surgical management or the management of post pneumonectomy empyema.