Comparison between Pleurodesis Effects with Bleomycin and Tetracycline on the Management of Patients suffering from malignant pleural Effusion in the Rasht Hospitals

Pleural effusion is developed in %17 of patients with malignancies. Malignant pleural effusions are commonly managed with tube thoracostomy drainage followed by chemical pleurodesis. Both tetracycline and bleomycin have been shown to be safe & effective for intrapleural instillation, although neither agent has definitively proved better than the other. The aim of the present study was to compare the efficacy of these two agents in terms of response rate. A prospective, randomized trial was carried out in Rasht Hospitals. Between July 2011 and January 2013, 118 patients with malignant pleural effusion were allocated to receive either intrapleural tetracycline (1.5 g) or bleomycin (1 U/kg) after drainage by tube thoracostomy. Response was evaluated at 4 and 8 weeks after pleurodesis. Demographic, clinical and fluid parameter findings were comparable in both groups. No statistically significant differences were found in terms of efficacy for two drugs used. Overall, 11 (18.64%) and 15 (25.42%) patients had a recurrence of pleural effusion during follow-up in the tetracycline and bleomycin arms, respectively. Considering the comparable efficacy of both agents used for pleurodesis and no superiority of one over the other in this trial, we suggest that economic costs and drug availability should be considered in selection of a