Voriconazole pleural lavage for fungal empyema
Efficacy of Pleural Lavage With Antifungals in the Management of Fungal Empyema Thoracis: A Prospective Cohort Study
This trial will try washing the infected pleural space with voriconazole in people of any age who have confirmed fungal empyema and are already receiving systemic antifungal therapy.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 50 (estimated) |
| Sex | All |
| Sponsor | University of Health Sciences Lahore Academic / other |
| Locations | 1 site (Lahore, Punjab Province) |
| Trial ID | NCT07337993 on ClinicalTrials.gov |
What this trial studies
This is a prospective cohort study at the Department of Thoracic Surgery, Services Hospital Lahore, enrolling patients with fungal empyema confirmed by pleural fluid culture or cytology. Enrolled patients must have adequate pleural drainage through an intercostal chest tube and be on systemic antifungal therapy. The intervention is pleural lavage with voriconazole, used either as a preoperative adjunct before decortication or as a conservative measure for patients unfit for surgery. Outcomes will focus on pleural sterilization, clinical recovery, safety measures including hepatic tolerability, and the need for subsequent surgical intervention.
Who should consider this trial
Good fit: Patients of any age with confirmed fungal empyema who have adequate chest tube drainage, are receiving systemic antifungal therapy, and are either scheduled for decortication or deemed unfit for surgery.
Not a fit: Patients with bacterial-only empyema, known hypersensitivity to antifungals, severe hepatic impairment (Child-Pugh C), or who are pregnant or breastfeeding are unlikely to benefit from this intervention.
Why it matters
Potential benefit: If successful, intrapleural voriconazole lavage could help sterilize the pleural space, control sepsis, reduce hospital stay, and lower the need for high-risk surgery in patients with fungal empyema.
How similar studies have performed: Intrapleural antifungal therapy is poorly studied and evidence is limited to case reports and small series that suggest possible benefit but no large controlled trials.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * All age patients with confirmed fungal empyema thoracis. * Patients with adequate pleural drainage through an intercostal chest tube. * Patients receiving systemic antifungal therapy. * Patients either: 1. scheduled for surgical decortication but undergoing lavage as a preoperative adjunct, or 2. considered unfit for surgery and managed conservatively. Exclusion Criteria: * Bacterial empyema without fungal growth. * Known hypersensitivity to anti-fungals. * Severe hepatic impairment (Child-Pugh class C) contraindicating voriconazole. * Pregnancy or lactation. * Refusal to participate.
Where this trial is running
Lahore, Punjab Province
- Services Hospital Lahore — Lahore, Punjab Province, Pakistan (Recruiting)
Study contacts
- Study coordinator: Zeeshan Sarwar, MBBS
- Email: zeeshan.sarwar195@gmail.com
- Phone: +923214347410
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.