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Intrapleural Tetracycline for the Prevention of Recurrent Spontaneous Pneumothorax: Results of a Department of Veterans Affairs Cooperative Study
Abstract
This prospective, multicenter, randomized, "unblinded," controlled clinical trial was designed to determine if the intrapleural instillation of 1500 mg of tetracycline hydrochloride would be effective in diminishing the ipsilateral rate of recurrence for spontaneous pneumothorax. During the 4-year enrollment period, 113 patients were assigned to the tetracycline group; 116 patients were assigned to the control group. During the 5-year study period, the recurrence rate in the tetracycline group (25%) was significantly less than that in the control group (41%). Use of tetracycline seemed to reduce the recurrence rates for patients with either primary or secondary spontaneous pneumothorax and for patients with either an initial or a recurrent pneumothorax. We conclude that the intrapleural administration of tetracycline in patients with spontaneous pneumothorax significantly reduces the rate of ipsilateral recurrence but is associated with intense chest pain. Intrapleural tetracycline therapy is indicated for patients with a spontaneous pneumothorax who are hospitalized and are treated with tube thoracostomy.
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“Use of pleurodesis was only demonstrated to allow a median recurrence-free interval of 61 mo in 28 patients.”
From Thoracic Endometriosis Syndrome: A Review of Diagnosis and Management (2019) · cites this paper as [62]
In the citing paper
“It was reported to decrease the recurrence rate of pneumothorax after VATS by 20%–25% compared with those who did not have pleurodesis performed at the time of surgery.51,62,63”
From Thoracic Endometriosis Syndrome: A Review of Diagnosis and Management (2019) · cites this paper as [62]
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Metadata
- Authors
- Light, R. W.
- Corresponding author
- Light, Richard W.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 1990-11-07
- Volume
- 264
- Issue
- 17
- Pages
- 2224
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W4232485545
- Cited by
- 220
- References
- 0
- Citations by year
- 2025: 3 · 2024: 5 · 2023: 6 · 2022: 5 · 2021: 2 · 2020: 6 · 2019: 4 · 2018: 8 · 2017: 3 · 2016: 9 · 2015: 6 · 2014: 5 · 2013: 3 · 2012: 6
- FWCI
- 9.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pleural and Pulmonary Diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pneumothorax, Barotrauma, Emphysema
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Keywords
- spontaneous pneumothorax, recurrent pneumothorax, tetracycline hydrochloride, pneumothorax recurrence prevention, chest tube drainage, chest pain, primary spontaneous pneumothorax, secondary spontaneous pneumothorax, veterans
- MeSH terms
- Adult, Aged, Humans, Injections, Male, Middle Aged, Pleura, Pneumothorax, Prospective Studies, Recurrence, Respiratory Function Tests, Tetracycline, Veterans
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