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Article
March 6, 1991

Intrapleural Tetracycline for Recurrent Pneumothorax-Reply

Author Affiliations

Veterans Affairs Medical Center Long Beach, Calif

Veterans Affairs Medical Center Long Beach, Calif

JAMA. 1991;265(9):1110-1111. doi:10.1001/jama.1991.03460090058020
Abstract

In Reply.—  Dr Corboy disagrees with our recommendation that patients who are hospitalized and are treated with tube thoracostomy should receive intrapleural tetracycline. Rather, he maintains that patients with their first spontaneous pneumothorax should be treated with tube thoracostomy; then, if there is a recurrent pneumothorax, the patient with primary spontaneous pneumothorax should be treated surgically while the patient with secondary spontaneous pneumothorax should be treated with intrapleural tetracycline.We still maintain that patients with spontaneous pneumothorax who are treated with tube thoracostomy should receive intrapleural tetracycline. The intrapleural administration of tetracycline will decrease the likelihood of recurrence by approximately 40%. Then, if the patient has a recurrent pneumothorax after the tetracycline pleurodesis, we would agree with Dr Corboy that the patient should be subjected to thoracotomy. We would perform a thoracotomy in this situation whether the patient had a primary or a secondary spontaneous pneumothorax. Essentially the intrapleural instillation

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