Patients with pleural infection should be managed with antibiotics and drainage of the pleural cavity. If medical management fails or is not possible, referral for surgical management should be considered. Intrapleural fibrinolytic treatment with alteplase (tPA) and dornase alfa (DNase) may be considered as an adjunct to medical management in selected patients at the discretion of the Respiratory Consultant. This guideline details the rationale, indications, contraindications and protocol for administering intrapleural fibrinolytic treatment.

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