Efficacy of Doxycycline in Pleurodesis in Cases of Malignant Pleural Effusion

Abstract

Introduction: Pleural effusions are well-reported entities in Pulmonology department and malignant effusion poses a great difficulty not only for diagnosis but also in terms of its management. Objective: To determine the efficacy of doxycycline in pleurodesis in cases of malignant pleural effusions (MPE). Study Design: Descriptive cases series. Setting: Department of Pulmonology, Sheikh Zayed Medical College / Hospital, Rahim Yar Khan. Duration: February 2016 to February 2017. Sample size: Fifty cases of malignant pleural effusion. Sampling technique: Non probability convenience sampling. Data collection procedure: In this study, 50 patients of both genders with age range of 15 to 70 years diagnosed with malignant pleural effusion were enrolled. Ten capsules of Doxycycline were mixed with 50 ml of normal saline and injected intra pleurally. The cases were then followed on next day and after one week and then one month by USG and CXR PA view. The failure of recollection of fluid more than 100 ml assessed on USG was labeled with positive efficacy. Results: In the present study, there were 50 cases of malignant pleural effusion (MPE) out of which 34 (68%) were females and 16 (32%) males, with mean age of 36.18± 10.16 years. The efficacy was seen in 26 (52%) of cases. It was better in males where it was seen in 10 (62.50%) of cases as compared to 16 (47.06%) females in their respective groups with p= 0.32. This was better in age group 15 to 40 years where it was seen in 60% of cases as compared to 40% in age group more than 40 with p= 0.08. There was significant better efficacy (p= 0.002) in cases that had pleural effusion less than 1 liter at presentation. Conclusion: Doxycycline is a cheaper easily available sclerosing agent with successful pleurodesis in half of the cases with MPE. Its failure rate is significantly higher in cases that had pleural effusion more than 1 liter at presentation.