Duration of therapy for complicated parapneumonic effusion or empyema complicating CAP in adults

In adults with parapneumonic effusion or empyema complicating CAP, the total duration of therapy (intravenous + oral) is usually 3 to 4 weeks, depending on the response to therapy and achievement of source controlDavies, 2010. If clinical response is rapid and the pleural space is adequately drained, a shorter duration may be sufficient – seek expert advice. Rarely, a longer duration of therapy (eg up to 6 weeks in the absence of effective source control) is required – seek expert advice. Duration should be guided by clinical status, inflammatory markers (C-reactive protein [CRP]) and residual fluid volume on imaging.