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Revista Cubana de Pediatría

Print version ISSN 0034-7531On-line version ISSN 1561-3119


LORET DE MOLA BUENO, Yanet de los Ángeles; MUZIO GONZALEZ, Verena Lucila  and  HERNANDEZ-BERNAL, Francisco. Effectiveness and security of recombinant streptokinase in children with parapneumonic pleural efussion. Rev Cubana Pediatr [online]. 2020, vol.92, n.3, e1092.  Epub Sep 01, 2020. ISSN 0034-7531.


The parapneumonic pleural efussion as a complication of pneumonias adquired in the community by the pediatric population represents a health problem in the world and in Cuba. The use of intrapleural fibrinolytics is a good therapeutic option.


To evaluate the effectiveness and security of the use of recombinant streptokinase in the treatment of complex parapneumonic pleural efussion in children.


Phase III confirmatory clinical trial, monocentric, open, randomized and controlled (RPCEC00000292) - named as DENIS study- carried out from September 2018 to October, 2019. There were included children (from 1 to 18 years old) that met the selection criteria including voluntariness. All of them received the established conventional treatment and were distributed in two groups: I- experimental (recombinant streptokinase, intrapleural daily dose of 200 000 UI, 3 - 5 days); II- control (conventional therapy). The main variables were need of surgery and hospital stay. There were also assessed the adverse events.


55 children with the above mentioned disease were assessed; 34 of them (61.8%) were included in the study. Any of the patients of the experimental group required surgery, opposite to the control group that required it in a 25%. The hospital stay was significantly reduced in the group that had treatment with recombinant streptokinase. There were not any severe adverse events related to the experimental treatment.


When recombinant streptokinase was administered in the complex parapneumonic pleural efussion resulted in an efficient and safe method for the elimination of the septic focus, with a positive impact expressed in the reduction of complications, the need of surgical treatment and the hospital stay without presenting related adverse events while using it.

Keywords : parapneumonic pleural efussion; recombinant streptokinase; controlled clinical trial.

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