What is the treatment for pleurisy?

From the Guidelines

The treatment for pleurisy should prioritize addressing the underlying cause and managing symptoms, with a focus on reducing morbidity, mortality, and improving quality of life. Pleurisy treatment typically involves pain relief with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (400-800mg every 6-8 hours) or naproxen (250-500mg twice daily) 1. For bacterial infections, antibiotics specific to the identified pathogen should be prescribed, typically for 7-14 days, with consideration of guidelines such as those from the British Thoracic Society 1. Initial drainage of pleural infection should be undertaken using a small bore chest tube (14F or smaller) as recommended by recent guidelines 1. Decisions on the best treatment modality should be based on patient choice, and informed decision-making should include the role of inpatient versus ambulatory management and the potential risk of requiring further pleural interventions 1. The choice of surgical approach, if necessary, should consider the best clinical outcomes, with options including endoscopic techniques like VATS or open techniques like thoracotomy 1. It's essential to consider the most recent and highest quality studies when making treatment decisions, prioritizing patient-centered care and evidence-based practice to optimize outcomes in terms of morbidity, mortality, and quality of life. Key aspects of treatment include:

• Addressing the underlying cause
• Managing symptoms, particularly pain
• Use of antibiotics for bacterial infections
• Drainage procedures for pleural effusion
• Consideration of surgical intervention when necessary
• Patient-centered decision-making
• Evidence-based practice guided by recent and high-quality studies 1.

From the Research

Treatment of Pleurisy

The treatment of pleurisy typically consists of pain management with nonsteroidal anti-inflammatory drugs, as well as specific treatments targeted at the underlying cause 2, 3.

• Pain management: Nonsteroidal anti-inflammatory drugs are appropriate for pain management in those with virally triggered or nonspecific pleuritic chest pain 3.
• Underlying cause treatment: The treatment is guided by the underlying diagnosis, and specific treatments may be necessary for conditions such as pulmonary embolism, pericarditis, pneumonia, and pneumothorax 2, 3.
• Pleural effusion treatment: For pleural effusion, treatment depends on the etiology, and may include thoracocentesis, laboratory testing, and management of the underlying medical disorder 4.
• Antibiotic treatment: For pleural infections, antibiotic treatment is necessary, and the optimal duration of antibiotics is still being studied, with some trials suggesting that shorter courses may be effective in certain cases 5.
• Other treatments: Other treatments, such as pleural drainage, intrapleural therapy, or surgery, may be necessary in certain cases, and the management of pleural infections should be individualized based on the specific circumstances 6.

Specific Treatments

• Viral pleurisy: Treatment of viral pleurisy typically consists of pain management with nonsteroidal anti-inflammatory drugs 2, 3.
• Bacterial pleurisy: Treatment of bacterial pleurisy typically consists of antibiotic treatment, and may also include pleural drainage and other supportive measures 4, 6.
• Pleural effusion: Treatment of pleural effusion depends on the etiology, and may include thoracocentesis, laboratory testing, and management of the underlying medical disorder 4.