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Free Content Minocycline and talc slurry pleurodesis for patients with secondary spontaneous pneumothorax

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Abstract:

SETTING: Few studies have evaluated the sclerosing efficacy of minocycline, and none have specifically compared its sclerosing efficacy and safety profiles with talc slurry in secondary spontaneous pneumothorax (SSP).

DESIGN: A retrospective analysis was conducted in patients with SSP who underwent chemical pleurodesis from January to December 2004 with minocycline or talc slurry in 12 public hospitals of Hong Kong.

RESULT: There were 121 episodes of minocycline pleurodesis and 64 episodes of talc slurry pleurodesis. Immediate procedural failure were similar in the minocycline and talc slurry groups (21.5% vs. 28.1%, P = 0.31). Presence of interstitial lung disease, ≥2 previous episodes of pneumothorax, requiring mechanical ventilation during pleurodesis and persistent air leak before pleurodesis were independently associated with procedural failure. Pain was experienced in respectively 44.6% and 37.5% of the minocycline and the talc slurry groups. Pain was more common in patients receiving high doses of talc (≥5 g; P = 0.03). Respiratory distress was found in respectively 1.7% and 1.6% of the minocycline and talc slurry groups.

CONCLUSION: Minocycline and talc slurry had comparable sclerosing efficacy in SSP, with immediate success rates of >70%. Pain was the most common adverse effect and respiratory distress was uncommon. Both appeared to be effective and safe for chemical pleurodesis in SSP.

Keywords: adverse effects; minocycline; pleurodesis; secondary spontaneous pneumothorax; talc slurry

Document Type: Regular Paper

Affiliations: 1: Department of Medicine, Queen Elizabeth Hospital, Hong Kong, Hong Kong SAR, China 2: Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, Hong Kong SAR, China 3: Department of Medicine, Ruttonjee and Tang Shiu Kin Hospital, Hong Kong, Hong Kong SAR, China 4: Department of Medicine, Kwong Wah Hospital, Hong Kong, Hong Kong SAR, China 5: Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR, China 6: Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China 7: Department of Medicine, Caritas Medical Centre, Hong Kong, Hong Kong SAR, China 8: Department of Medicine, North District Hospital, Hong Kong, Hong Kong SAR, China 9: Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, Hong Kong SAR, China 10: Department of Medicine, Tseung Kwan O Hospital, Hong Kong, Hong Kong SAR, China 11: Respiratory Medical Department, Grantham Hospital, Hong Kong, Hong Kong SAR, China 12: Department of Cardiothoracic Surgery, Queen Elizabeth Hospital, Hong Kong, Hong Kong SAR, China 13: Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, Hong Kong SAR, China

Publication date: October 1, 2010

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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