{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T16:32:30Z","timestamp":1740155550023,"version":"3.37.3"},"reference-count":22,"publisher":"European Respiratory Society (ERS)","issue":"4","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ersjournals.com"],"crossmark-restriction":true},"short-container-title":["Breathe"],"accepted":{"date-parts":[[2023,10,8]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>The data about the optimal duration of antibiotics and the usefulness of corticosteroids in the management of parapneumonic effusion and pleural infection are scarce. Two randomised controlled trials evaluating short antibiotic courses (ODAPE and SLIM) and another trial assessing the benefit from corticosteroid use (STOPPE) in this setting were recently published. The aim of this journal club is to present these trials and discuss their significance and limitations. ODAPE compared the efficacy and safety of a short (2\u2005weeks)<jats:italic>versus<\/jats:italic>an extended (3\u2005weeks) course of amoxicillin\u2013clavulanate in community-acquired complicated parapneumonic effusions, while SLIM compared the efficacy and safety of short (14\u201321\u2005days)<jats:italic>versus<\/jats:italic>longer (28\u201342\u2005days) antibiotic courses in patients with community- or hospital-acquired pleural infection. STOPPE assessed the benefit from dexamethasone use in patients with community-acquired pneumonia and concomitant pleural effusion. Both ODAPE and SLIM found that shorter antibiotic courses produce less adverse events while being equally efficacious to the longer courses in a subgroup of patients, such as those with pleural infection that is stabilised with only medical treatment and does not require surgery. In contrast, STOPPE found no benefit from the use of dexamethasone in unselected patients with pneumonia and pleural effusion. Due to the significant limitations of these trials, further studies are required to confirm these findings.<\/jats:p><jats:sec><jats:title>Commentary on:<\/jats:title><jats:list list-type=\"bullet\"><jats:list-item><jats:p>Hassan M,<jats:italic>et al<\/jats:italic>. The Short<jats:italic>versus<\/jats:italic>Long Antibiotic Course for Pleural Infection Management (SLIM) randomised controlled open-label trial.<jats:italic>ERJ Open Res<\/jats:italic>2023; 9: 00635-2022.<\/jats:p><\/jats:list-item><jats:list-item><jats:p>Porcel JM,<jats:italic>et al<\/jats:italic>. Two<jats:italic>vs<\/jats:italic>. three weeks of treatment with amoxicillin\u2013clavulanate for stabilized community-acquired complicated parapneumonic effusions. A preliminary non-inferiority, double-blind, randomized, controlled trial.<jats:italic>Pleura Peritoneum<\/jats:italic>2020; 5: 20190027.<\/jats:p><\/jats:list-item><jats:list-item><jats:p>Fitzgerald DB,<jats:italic>et al<\/jats:italic>. Steroid Therapy and Outcome of Parapneumonic Pleural Effusions (STOPPE): a pilot randomized clinical trial.<jats:italic>Am J Respir Crit Care Med<\/jats:italic>2022; 205: 1093\u20131101.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:sec>","DOI":"10.1183\/20734735.0134-2023","type":"journal-article","created":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T16:25:10Z","timestamp":1703003110000},"page":"230134","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Medical treatment of pleural infection: antibiotic duration and corticosteroid usefulness"],"prefix":"10.1183","volume":"19","author":[{"given":"Vasileios","family":"Skouras","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4698-3458","authenticated-orcid":false,"given":"Foteini","family":"Chatzivasiloglou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianthi","family":"Iliopoulou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theofani","family":"Rimpa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"81","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"key":"2024101704101611000_19.4.230134.1","unstructured":"Light RW . 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