Nav: Home

AATS issues new consensus statement for treatment of empyema

April 20, 2017

Beverly, MA, April 20, 2017 - Although treatable, empyema is a potentially deadly accumulation of pus around the lungs, occurring most commonly as a complication of pneumonia. To better manage this disease in the face of rising demand for treatment, the American Association for Thoracic Surgery (AATS) Guidelines Committee called for the formation of the Empyema Management Guidelines Working Group. Comprised of experts from a variety of disciplines including thoracic surgery, pulmonary and critical care medicine, infectious diseases, and interventional radiology, the group was tasked with analyzing the latest literature about empyema and issuing new evidence-based clinical guidelines. The resulting Consensus Statement is published in the

In the United States, around 1 million patients each year are hospitalized with pneumonia. Of this group, around 20% to 40% develop a parapneumonic effusion and 5%-10% of these will progress to empyema. Patients who experience empyema face discouraging odds: approximately 15% of them will die and 30% will require surgical draining to clear the infection. While occurrences of empyema dropped dramatically during first half of the 20th century thanks to improved antibiotic regimens, that trend changed in the 1990s. Now, doctors are seeing more cases, making empyema an even more relevant subject for clinical study.

"The management of empyema has historically varied significantly from hospital to hospital and across the many different medical specialists who may care for patients with this disease," remarked lead author K. Robert Shen, MD, Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN. "These new guidelines formulated by the AATS are important because they represent an attempt to develop recommendations that are based upon the best available current scientific evidence.

The guidelines encompass empyema presentation, diagnosis, and treatment presenting a comprehensive strategy for doctors treating empyema patients. There are several top-level takeaways from their findings:
  • Patients with pneumonia that fail to respond to established antibiotic therapy or unexplained sepsis should always be evaluated for a possible pleural effusion. If either a parapneumonic effusion or empyema is found, patients should undergo immediate treatment.

  • According to the group's findings, surgery remains the most effective method for management of most patients with empyema despite advances in radiologic imaging, antibiotics, and other medications that have made it possible to treat without undergoing a surgical procedure.

  • Management of pediatric empyema differs significantly from treatment in adults. Investigators acknowledge there is currently disagreement about the best treatment protocols for children with empyema. After a comprehensive analysis of current literature, the group issued a recommendation that pediatric patients should initially be treated with a tube thoracostomy with or without the subsequent instillation of fibrinolytic agents.

As empyema cases become increasingly common, investigators hope these guidelines can help make diagnosis and treatment protocols more uniform across the country to help offer patients the best care possible. "Despite the widespread use of antibiotics and availability of pneumococcal vaccines, empyema remains the most common complication of pneumonia and an important cause of morbidity and mortality worldwide," concluded Dr. Shen. "It is hoped that these guidelines will provide clinicians who care for pneumonia patients with practical guidelines on the best way to treat their patients who develop empyema."

American Association for Thoracic Surgery

Related Pneumonia Articles:

Pneumonia recovery reprograms immune cells of the lung
Researchers have determined that after lungs recover from infection, alveolar macrophages (immune cells that live in the lungs and help protect the lungs against infection) are different in multiple ways and those differences persist indefinitely.
Skin and mucous membrane lesions as complication of pneumonia
Painful inflammatory lesions of the skin and mucous membranes may occur in children who develop bacterial pneumonia.
Vaccine reduces likelihood of severe pneumonia
A new study has found severe pneumonia decreases by 35 per cent in children who receive a vaccine against a pneumonia-causing bacteria.
Bacteria in pneumonia attack using bleaching agent
Research shows that bacteria use hydrogen peroxide to weaken the immune system and cause pneumonia.
Many kids with pneumonia get unnecessary antibiotics, chest X-rays
Preschool children with community-acquired pneumonia often receive unnecessary tests and treatment at outpatient clinics and emergency departments, according to a nationally representative study led by Todd Florin, M.D., MSCE, from Ann & Robert H.
Certain psychiatric drugs linked with elevated pneumonia risk
A review of published studies indicates that use of benzodiazepines and benzodiazepine related drugs (BZRDs), which are prescribed to treat various psychiatric diseases, may increase the risk of pneumonia.
Bacterial pneumonia far more dangerous to the heart than viral pneumonia, study finds
Heart complications in patients diagnosed with bacterial pneumonia are more serious than in patients diagnosed with viral pneumonia, according to new research.
Research suggests vapers are vulnerable to pneumonia
The vapor from e-cigarettes seems to help pneumonia-causing bacteria stick to the cells that line the airways, according to research published in the European Respiratory Journal.
Pneumonia: Treatment with vaccines instead of antibiotics
A properly functioning immune system is key to resolve bacterial pneumonia.
The end of pneumonia? New vaccine offers hope
A new vaccine under development provoked an immune response to 72 forms of the bacteria that's responsible for pneumonia, sepsis and meningitis.
More Pneumonia News and Pneumonia Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

There's so much we've yet to explore–from outer space to the deep ocean to our own brains. This hour, Manoush goes on a journey through those uncharted places, led by TED Science Curator David Biello.
Now Playing: Science for the People

#556 The Power of Friendship
It's 2020 and times are tough. Maybe some of us are learning about social distancing the hard way. Maybe we just are all a little anxious. No matter what, we could probably use a friend. But what is a friend, exactly? And why do we need them so much? This week host Bethany Brookshire speaks with Lydia Denworth, author of the new book "Friendship: The Evolution, Biology, and Extraordinary Power of Life's Fundamental Bond". This episode is hosted by Bethany Brookshire, science writer from Science News.
Now Playing: Radiolab

Dispatch 2: Every Day is Ignaz Semmelweis Day
It began with a tweet: "EVERY DAY IS IGNAZ SEMMELWEIS DAY." Carl Zimmer – tweet author, acclaimed science writer and friend of the show – tells the story of a mysterious, deadly illness that struck 19th century Vienna, and the ill-fated hero who uncovered its cure ... and gave us our best weapon (so far) against the current global pandemic. This episode was reported and produced with help from Bethel Habte and Latif Nasser. Support Radiolab today at