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Chemical pleurodesis with doxycycline 1 g
J D Herrington1, M L Gora-Harper, R K Salley
1Department of Pharmacy, University of Kentucky Chandler Medical Center, Lexington 40536-0084, USA.
Pharmacotherapy
|March 1, 1996
Summary
A single 1-gram dose of doxycycline showed promise for treating pleural effusions and pneumothoraces. This dose was found to be safe and effective in most patients, warranting further comparison with standard treatments.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Pharmacology
Background:
- Pleural effusions and pneumothoraces are common thoracic conditions requiring intervention.
- Pleurodesis is a standard procedure to manage these conditions.
- Doxycycline is an antibiotic with potential anti-inflammatory properties for pleurodesis.
Purpose of the Study:
- To evaluate the efficacy and safety of a single 1-gram dose of doxycycline for pleurodesis.
- To assess doxycycline's utility in treating malignant and nonmalignant pleural effusions and refractory pneumothoraces.
Main Methods:
- A single 1-g dose of doxycycline in saline was instilled intrapleurally in 27 patients after fluid/air evacuation.
- Patients received premedication with analgesics and lidocaine.
- Chest tubes were removed when drainage was <150 ml/day; outcomes assessed at 30 days.
Main Results:
- A 67% response rate was observed in nine patients with pneumothoraces.
- Both patients with nonmalignant pleural effusions achieved a complete response.
- In 12 patients with malignant pleural effusion, 67% had a complete response, 17% partial, and 17% no response.
- Pain (81%) and fever (11%) were the most common adverse effects.
Conclusions:
- A single 1-g intrapleural doxycycline dose appears safe and effective for managing pleural effusions and pneumothoraces.
- Further studies are needed to compare this dose with the standard 500-mg dose and other agents.