Management of patients with pleural infection in Greece: initial results of the ongoing PRACTICE (PleuRAl InfeCTIon in GreeCE) study

Title:Management of patients with pleural infection in Greece:initial results of the ongoing PRACTICE(PleuRAl InfeCTIon in GreeCE)study <bold>Introduction:</bold> The healthcare-associated burden of pleural infection remains high due to the increasing incidence and the unimproved prognosis of the disease, which is characterized by prolonged(10–12 days)hospitalization and significant mortality(10%). The absence of progress in the management of the disease is attributed to the lack of large studies <bold>Purpose:</bold> To record the characteristics, diagnostic approach, treatment and outcome of patients with community-acquired pleural infection in Greece Method:Multicenter study of patients with pleural infection, hospitalized from May 2022 to July 2023 <bold>Results:</bold> The study included 62 patients(male:81%,mean age:62 years),usually complaining of chest pain(69%),fever(66%),cough(47%) and dyspnea(40%). Common CXR included effusion not exceeding half of the hemithorax(63%),pleural loculations(70%)and pleural thickening(63%). Purulent pleural fluid was found in ¼ of patients while pH<7.20,glucose<60 mg/dl or positive culture was observed in 68%,60% and 34% of them, respectively. Chest tube was placed in 84% of patients while 42% of them received intrapleural fibrinolytics. Initial antibiotic therapy included penicillin/β-lactamase inhibitor(63%),linezolid(47%),quinolone(32%)and/or carbapenem(18%). Median length of hospital stay was 15.8 days and 30-day mortality:3% <bold>Conclusion:</bold> Most patients had moderate pleural effusion with loculations. Initial treatment with carbapenem was administered in 18% while 15% was treated without chest tube placement. Longer hospitalization and lower mortality were observed