The use of intrapleural fibrynolisis in the treatment of empyema shortens hospital stay and is recommended by international guidelines in children with a B grade of evidence. Even though only few randomized studies have addressed this issue in limited series of patients with conflicting results. One trial for urokinase showed a positive result while another trial with streptokinase did not show a significant reduction in length of hospital stay. We retrospectively rewied a 30 year experience in a third level university hospital comparing length of treatment in a group of children treated with simple drainage and a group treated with urokinase. Even if such a retrospective analysis is limited by possible biases which are highlighted and discussed a significant reduction in length of hospital stay was found without side effects.
