MIST1

A randomised, double blind, placebo controlled study to assess the efficacy and safety of intra-pleural streptokinase in pleural empyema

Can a drug called streptokinase help to treat people with an infection around their lungs?

What was this study about?

Pleural infection (or empyema) - an infection of the area around the lungs - can occur when people have lung diseases such as pneumonia. Doctors often try to drain the fluid around the lungs to try to treat this. But sometimes this can be hard to do successfully. Some people have to have an operation, and some people may die as a result of the infection.

The MIST trial aimed to find out whether a drug called streptokinase could help to treat people with pleural infection. People who took part in this trial were allocated at random into one of two groups. People in one group were treated with streptokinase. People in the other group were given a matching placebo.

What difference did this study make?

The trial provided strong evidence that streptokinase should not be used in pleural infection and resulted in changes in the guidelines for management of pulmonary empyema

Type of study

Randomised trial

Who funded the study?

The Medical Research Council.

When did it take place?

This trial recruited patients between 1999 and 2002

Where did it take place?

52 hospitals across the UK

Who was included?

454 patients with pleural infection