CompletedInterventional

A randomised study to assess the feasibility of treating patients with pleural infection according to the RAPID score, compared with usual care based on the British Thoracic Society Pleural Disease Guidelines

This study investigates different ways to treat pleural infection, a serious lung infection where fluid builds up around the lung. It's a common condition affecting many people each year in the UK and can be very serious. Currently, treatment often involves antibiotics and draining the fluid, but sometimes more intensive treatments or surgery are needed. This research compares the usual treatment approach with a new method. The new method uses a special score called RAPID, which helps doctors quickly identify how severe a patient's infection is. The aim is to see if using this score can help deliver the right treatment at the right time, potentially shortening hospital stays and improving recovery. This pilot study will help decide if a larger trial should be done.

At a glance

Status

Completed

Sponsor

University of Oxford

Enrolment target

Start

05 Nov 2025

Estimated completion

01 Jun 2026

Pleural infection

What is this study about?

Pleural infection is a common and serious problem where fluid collects between your lung and the inside of your chest wall. It often happens after a lung infection like pneumonia. Each year, thousands of people in the UK get this condition, and it can be quite severe, with many patients needing long hospital stays. The usual treatment involves antibiotics and draining the fluid using a tube inserted into the chest. For some, this isn't enough, and they might need special medication given through the chest tube or even surgery.

Doctors want to find better ways to treat pleural infection. They've developed a simple scoring system called RAPID, which uses information gathered when you first arrive at the hospital. This score helps predict how serious a patient's infection is likely to be and who might need more intensive treatment. The main idea of this study is to see if using the RAPID score to decide on treatment can lead to better care than the current standard approach.

This particular study is a "feasibility study," which means researchers are checking if it's practical and acceptable to both patients and doctors to use this RAPID score to guide treatment. If successful, it would pave the way for a bigger study. Ultimately, the goal is to make sure patients get the most effective treatment for their pleural infection as quickly as possible, which could mean shorter hospital stays, less suffering, and a better chance of recovery.

Key takeaways

Compares standard care with RAPID score-guided treatment for pleural infection.
Aims to get the right treatment to patients more efficiently.
Could potentially lead to shorter hospital stays and better recovery.
No new treatments, uses existing approved methods.
This is a 'pilot' study to see if a larger trial would work.

Who may be eligible?

To be part of this study, you need to be an adult (18 years or older) who has been diagnosed with a pleural infection and requires hospital care. This means that doctors have found fluid around your lung and tests show that it's infected.

There are certain situations where you wouldn't be able to join. For example, if you've already had a lung removed on the infected side, or if the fluid collection can't be drained with a chest tube. You also wouldn't be eligible if you've recently had specific treatments for this infection or if you're pregnant or breastfeeding. Patients with unrelated serious illnesses that significantly shorten their life expectancy are also not suitable for this study, nor are those unable to provide their own consent.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you 18 years old or older?
Do you have a confirmed pleural infection requiring hospital care?
Are you able to give your informed consent?
Have you had specific previous treatments for this current infection?
Are you pregnant or breastfeeding?

Answer every question to see your result.

What does participation involve?

If you join this study, you'll be randomly placed into one of two groups. One group will receive the standard treatment for pleural infection, which includes antibiotics and a chest drain. If needed, your doctors will decide to escalate treatment with special medications or surgery based on how you respond over a few days.

The other group will have a RAPID score calculated. If your score is low, you might have a chest drain for a shorter time or just have fluid removed, alongside antibiotics, and then go home with quick follow-up. If your score is higher, you'll receive a chest drain, immediate special medications (IET), and doctors will consider surgery early on. All participants will be asked to keep a diary about their breathing and pain, and to attend follow-up appointments at 2 and 4 weeks in person, and 12 weeks over the phone. These appointments will involve routine checks like blood tests, X-rays, and ultrasound scans. Some participants may also be asked to share their experiences in an interview.

Potential risks and benefits

There are no extra clinical risks in this study compared to standard care, as all treatments used are approved and are part of routine NHS practice for pleural infection. The potential benefits for patients include getting the most appropriate treatment for their condition more quickly, which could lead to shorter hospital stays, less need for surgery, and an improved quality of life. For those with a lower RAPID score, it might mean less intensive treatment. However, it's important to know this is a feasibility study, so direct health changes for individuals are not guaranteed at this stage. You are free to withdraw from the study at any time without affecting your medical care.

Locations (4)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

Oxford University Hospitals NHS Foundation Trust
City only
Oxford, United Kingdom
Norfolk and Norwich University Hospitals NHS Foundation Trust
City only
Norwich, United Kingdom
Royal Devon University Healthcare NHS Foundation Trust
City only
Exeter, United Kingdom
University Hospitals Plymouth NHS Trust
City only
Plymouth, United Kingdom

Common questions

What is pleural infection?

It's a serious chest infection where a pocket of infected fluid collects between your lung and the inside of your chest wall.

What is the RAPID score?

It's a simple scoring system doctors can use to quickly tell how severe your pleural infection is, helping them decide on the best treatment.

Will I get different treatment if I join this trial?

You'll either receive the usual care that doctors currently recommend, or treatment guided by the RAPID score, which might mean earlier or less intensive interventions depending on your score.

How long will the study last for me?

You'll be followed up during your hospital stay and then with visits at 2 and 4 weeks after leaving hospital, and a phone call at 12 weeks. The study itself runs until September 2026.

Will I have to have surgery?

Surgery is a possibility for some people with more severe pleural infections, both in standard care and in the RAPID-guided group, if other treatments aren't working. This study aims to help identify who might benefit most from early intervention, including surgery.

How to find out more

Alguili Elsheikh

Alguili.elsheikh@ouh.nhs.uk +44 (0)1865 225552 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.