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Synopsis: Forty percent of patients with community-acquired pneumonia develop parapneumonic effusions despite appropriate antibiotic therapy, and these effusions may become infected. Tube thoracostomy, with adequate and early drainage, is the current accepted management, but it often fails as a result of adhesion formation and loculations. The use of intrapleural Streptokinase versus placebo was evaluated in 24 subjects with parapneumonic pleural effusions, with intrapleural Streptokinase aiding in the treatment and drainage of pleural infections by enhancing pleural drainage.Source: Davies RJO et al. Randomized controlled trial of intrapleural Streptokinase in community acquired pleural infection.