2026 Clinical Practice Guideline Update by the Infectious Diseases Society of America and the Pediatric Infectious Diseases Society on The Management of Community-acquired Pneumonia in Infants and Children Older than 3 Months of Age: The Use of tPa a
This paper is part of a larger clinical practice guideline on the diagnosis and management of parapneumonic effusion and empyema in children, developed by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. In this report, the panel provides recommendations for intrapleural fibrinolysis with tissue plasminogen activator (tPA) alone over tPA and dornase alfa (DNase) in children (3 months to 18 years) with complicated parapneumonic effusion and empyema. The panel's recommendations are based upon evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.
Authors
- Angela M. Statile
- Derek J. Williams (ORCID: https://orcid.org/0000-0003-0295-1240)
- Samir S. Shah (ORCID: https://orcid.org/0000-0001-7902-7000)
- Mark Sawyer (ORCID: https://orcid.org/0000-0001-6784-4492)
- Mark I. Neuman
- Michael D. Cabana (ORCID: https://orcid.org/0000-0001-9376-2167)
- Todd A. Florin (ORCID: https://orcid.org/0000-0002-4387-2605)
- Claudia Espinosa (ORCID: https://orcid.org/0000-0002-6085-1259)
- Michelle A. Gill
- Debra L. Palazzi
- Sheena Patel
- Krow Ampofo
- Shawn D St. Peter
- Thomas Brogan
- Jeffrey S Gerber
Institutions
- Cincinnati Children's Hospital Medical Center (US)
- Boston Children's Hospital (US)
- Albert Einstein College of Medicine (US)
- Children's Mercy Hospital (US)
- Children's Hospital of Philadelphia (US)
- Vanderbilt University (US)
- University of Utah (US)
- University of South Florida (US)
- Infectious Diseases Society of America (US)
- UC San Diego Health System (US)
- University of Florida (US)
- University of California San Diego (US)
- Seattle Children's Hospital (US)
- Pulmonary and Allergy Associates (US)
- Lurie Children's Hospital (US)
- Texas Children's Hospital (US)
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
Publication Details
- Journal
- Clinical Infectious Diseases
- Published
- 2026-03-17
- DOI
- https://doi.org/10.1093/cid/ciag191
- Primary Topic
- Pneumonia and Respiratory Infections
- Type
- article
- Field-Weighted Citation Impact
- 0.00