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The Oxford Respiratory Trials Unit (ORTU) at the Nuffield Department of Medicine has been awarded a £2.8 million grant from the National Institute for Health and Care Research Health Technology Assessment (NIHR HTA) to conduct the MIST4 study.

This study will provide definitive data on the optimal initial treatment for pleural infection, which is infected fluid in the chest cavity, a serious respiratory infection which affects around 25,000 patients a year in the UK alone. The study will address if initial use of surgery or use of a combination of enzymes given in to the chest cavity can help patients recover more quickly, improve quality of life and which is the more definitive treatment.

Professor Najib Rahman, Director of the Oxford Respiratory Trials Unit, chief investigator and CAMS Oxford Institute Principal Investigator, said 'It is an incredible honour to be awarded this grant to conduct a practice changing, definitive study in 25 centres in the UK. This will be the largest randomised study of pleural infection in the world, and will have an enormous impact on patients seen every day in the UK and across the world. Understanding the risks and benefits of each treatment, and defining which is optimal as first treatment for pleural infection patients is critical – this disease has very poor outcomes currently, and high quality data is desperately needed to improve the lives of our patients and inform the healthcare system with robust evidence.'