Duration of therapy for complicated parapneumonic effusion or empyema complicating HAP or VAP

In adults with complicated parapneumonic effusion or empyema complicating HAP or VAP, the total duration of therapy (intravenous + oral) is 3 to 4 weeksDavies, 2010.

In children, the total duration of therapy (intravenous + oral) is usually 2 to 3 weeks. If clinical response is rapid in children, stop antibiotic therapy 7 days after drainage of pleural fluid. Rarely, a long duration of therapy (eg up to 6 weeks) is required – seek expert adviceMcMullan, 2016.

For both adults and children, consider monitoring serum C-reactive protein (CRP) or residual fluid volume on thoracic ultrasound for response to treatment.