Alternative widely available, inexpensive agents for pleurodesis

Abstract

Pleurodesis is the one of the best options for the management of symptomatic patients with malignant pleural effusion, recurrent benign pleural effusion, and recurrent pneumothorax. Although talc, parenteral tetracycline derivatives, and bleomycin are the most commonly used agents for pleurodesis, parenteral tetracycline derivatives are not available worldwide, bleomycin is expensive, and concerns about the side effects of talc are growing. The purpose of this review is to provide information about other widely available agents for pleurodesis. It has recently been shown that oral tetracycline/doxycycline is as effective and safe as parenteral doxycycline in producing pleurodesis in rabbits. Oral forms of tetracycline derivatives, quinacrine, silver nitrate, iodopovidone, and other talc preparations such as facial talc can be used to create pleurodesis when commonly used agents are not available.