Treatment for life-threatening chest infection found to be ineffective
3 March 2005
A recent Medical Research Council (MRC) trial has found that a widely used treatment for a type of life threatening chest infection is essentially ineffective. The results of the study are to be published in full in this week’s edition of the New England Journal of Medicine.
Every year about 65,000 people in the UK and US develop an infection of the pleura – the membranes around the lungs – as a consequence of pneumonia. Of these people, 15% die and a further 15% require surgery.
Previous studies suggested that giving patients intra-pleural treatment with fibrinolytic drugs, such as streptokinase, was beneficial for pleural infections. This was on the basis of small trials and until now there has not been a trial big enough to provide definitive evidence of benefit.
The MRC study was specifically designed to answer this question and involved over 450 patients across 52 UK hospitals using a double blind randomised trial.
The trial, co-ordinated by MRC and supported by the British Thoracic Society, compared patients treated with streptokinase with patients on a placebo treatment. They found that there was no reduction in mortality of the patients who were treated with streptokinase compared with the placebo.
The team also looked specifically at whether streptokinase might reduce the need for drainage surgery or duration of hospital stay and found that again there was no difference between the treatment and the placebo groups.
Dr Robert Davies, the coordinator of the trial, from the Oxford Centre for Respiratory Medicine, said:
“This result has allowed us avoid the delay, costs and side effects associated with using a treatment which is actually ineffective. The trial has also collected a lot of information about pleural infection, which will allow us to identify earlier in their treatment patients who are likely to die or require major surgery. This will allow us to target extra care on the patients who most need it."
Professor Colin Blakemore, Chief Executive of the MRC, said:
“Pleural infection tends to occur in particular patient groups, such as the elderly, homeless and drug users, who are the most susceptible to pneumonia. This is an excellent example of how evidence from research contributes to changing clinical practice, with the potential to improve patient care.”
The team is currently studying other new treatments in a further clinical trial that may be effective in pleural infection.
Notes to Editors
The Medical Research Council (MRC) is a national organisation funded by the UK tax-payer. Its business is medical research aimed at improving human health; everyone stands to benefit from the outputs. The research it supports and the scientists it trains meet the needs of the health services, the pharmaceutical and other health-related industries and the academic world. MRC has funded work which has led to some of the most significant discoveries and achievements in medicine in the UK. About half of the MRC’s expenditure of £450 million is invested in its 40 Institutes, Units and Centres. The remaining half goes in the form of grant support and training awards to individuals and teams in universities and medical schools.
