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Comparisons of doxycycline solution with talc slurry for chemical pleurodesis and risk factors for recurrence in South Korean patients with spontaneous pneumothorax
  1. Eun Ha Park1,2,
  2. Joo Hee Kim3,4,
  3. Jeong Yee4,
  4. Jee Eun Chung5,
  5. Jong Mi Seong4,
  6. Hyen Oh La2,6,
  7. Hye sun Gwak1,4
  1. 1 Graduate School of Converging Clinical & Public Health, Ewha Womans University, Seoul, Republic of Korea
  2. 2 Department of Pharmacy, the Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
  3. 3 College of Pharmacy & Institute of Pharmaceutical Science and Technology, Ajou University, Suwon-si, Republic of Korea
  4. 4 College of Pharmacy & Division of Life and Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea
  5. 5 College of Pharmacy, Hanyang University, Ansan-si, Republic of Korea
  6. 6 College of Pharmacy, The Catholic University of Korea, Seoul, Republic of Korea
  1. Correspondence to Dr Hye sun Gwak, College of Pharmacy & Division of Life and Pharmaceutical Sciences, Ewha Womans University, Seoul 03760, Korea; hsgwak{at}ewha.ac.kr

Abstract

Purpose Talc slurry (TS) has been commonly used with high success rates in managing spontaneous pneumothroax (SP), but there were concerns of post-procedural complications. Alternatively, doxycycline solution (DS) was used successfully. This retrospective study aims to compare the effectiveness and safety between talc and doxycycline as a sclerosing agent and to investigate risk factors for recurrence in patients with SP.

Methods The review of medical records between January 2011 and December 2014 was conducted on 83 patients with SP who underwent pleurodesis with either TS (n=16) or DS (n=67). Recurrence and complications were compared between the DS and TS groups. Associations between recurrence after DS treatment and various factors were analysed.

Results Recurrence was significantly higher in the DS group than in the TS group (P=0.033), whereas complications were higher in the TS group than the DS group: fever was significantly higher in the TS group (P=0.001). Recurrences associated with doxycycline use were found significantly more often in patients with recurrent diagnosis of SP, height/weight ≥3.25 cm/kg and weight <55 kg.

Conclusion Talc was more effective without recurrence compared with doxycycline. Clinically insignificant fever associated with pleurodesis was more common with talc. Low weight, high height to weight ratio and recurrent diagnosis of SP were associated with higher recurrence after doxycycline treatment.

  • pneumothorax
  • doxycycline
  • talc
  • pleurodesis
  • recurrence

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