Assessment of Tetracycline Pleurodesis in Primary Spontaneous Pneumothorax

This study aims to assess tetracycline chemical pleurodesis through tube thoracostomy in prevention of spontaneous pneumothorax in patients with normal computed tomography (CT) scans following their first episode of primary spontaneous pneumothorax (PSP).

We conducted a prospective, double-blinded, census clinical trial involving 66 patients with spontaneous pneumothorax, referred to Isfahan University of Medical Sciences affiliated Hospitals. The patients were randomly divided into two groups. Tube thoracostomy was embedded for all patients. The first group was treated with tetracycline 2 g, 5 mL of lidocaine 2%, and 50 mL of normal saline injected through an embedded thoracostomy tube. The second group was performed with the same procedure without tetracycline injection. Thereafter, patients were followed up for 12 months.

This study was conducted on 32 (48.5%) cases and 34 (51.5%) controls. SPS recurrence occurred in 16 patients, with the following distributions: 14 males (P value = 0.627), 14 controls (P value = 0.001), and 12 smokers (P value = 0.207). Tetracycline pleurodesis correlated with a significantly lower recurrence rate (odds ratio [OR] =12.16; P value = 0.014).

Tetracycline chemical pleurodesis via thoracostomy tube in patients with first episode of PSP may significantly decrease the rate of recurrence. However, further large-scale clinical trials are needed to establish this effect.