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Intrapleural Tetracycline for Recurrent Pneumothorax

Kenneth Granke, MD
JAMA. 1991;265(9):1110. doi:10.1001/jama.1991.03460090058019.
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To the Editor. —  The study by Light et al1 points out a significant reduction in recurrent spontaneous pneumothoraces for those treated with intrapleural tetracycline vs only closed tube thoracostomy. I would like to say that this study is certainly excellent evidence for the consideration of tetracycline as the best agent for chemical pleurodesis, but it may give the readers the wrong impression that it is the best treatment for the prevention of recurrent spontaneous pneumothoraces.This study points out that a spontaneous pneumothorax is not a rare occurrence, and it is followed by a recurrence rate approaching 50%. It also seems to imply that thoracotomy with mechanical pleurodesis and bleb removal is undesirable because it is a "major" surgical procedure. Furthermore, it states that a recurrent spontaneous pneumothorax carries a mortality rate ranging from 1.4% (in their study) to as high as 16%. Finally, the authors conclude that


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