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John R. Corboy, MD
The Johns Hopkins Hospital Baltimore, Md

JAMA. 1991;265(9):1110.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The recent study by Light et al¹ on the use of intrapleural tetracycline to prevent recurrent spontaneous pneumothorax is an excellent example of a statistically significant improvement in outcome associated with an overall persistently poor outcome.

Although it was true that 41% of untreated patients had recurrence, so did an astounding 25% of men treated with a drug that caused severe chest pain in over half. Even patients with primary pneumothorax (who presumably were younger and healthier) had a 10.5% recurrence rate with treatment. Thoracotomy with pleural abrasion is associated with a low risk of serious complications, with the risk greatest in elderly patients with chronic obstructive pulmonary disease, but typically carries a recurrence rate of less than 1%.² Thus, a blanket recommendation to attempt intrapleural installation of tetracycline to prevent recurrent spontaneous pneumothorax is unjustified.

Given that treatment with intrapleural tetracycline still results in . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Deputy Editor (West), and Don Riesenberg, MD, Senior Editor.

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