Efficacy of Doxycycline as Peluridising Agent in Cases of Malignant Pleural Effusion (MPE)

ABSTRACT

Objective: To determine the efficacy of doxycycline as pleuridising agent in cases of malignant pleural effusions (MPE). Subject and methods: This was a descriptive case series that was conducted at Medical and Pulmonology Department of Combined Military Hospital Lahore from January 2018 to August 2018. In this study, the cases of malignant pleural effusion assessed on history and proven by histopathology on any biopsy of either gender falling in range of 30 years or more were included. The pleural fluid was drained by appropriate size intercostal chest tube (ICT). These cases then underwent pleurodesis with Doxycycline. For pleurodesis 10 capsule of Doxycycline each carrying 100 mg in it were taken and mixed with 50 ml of normal saline. A repeat chest X-ray and USG chest was done to see for presence of fluid, complete absence of fluid was labelled as efficacious pleurodesis. Results: In this study, there were total 60 cases of malignant pleural effusion (MPE) included, out of which 35 (58.33%) were females and 25 (41.67%) females. The mean age of the subjects was 57.32 ± 7.28 years. There were 29 (48.33%) cases with CA breast, 22 (36.67%) with CA lung and 9 (15%) had the other miscellaneous malignancies. The efficacy of pleurodesis with Doxycycline was seen in 26 (43.33%) of cases. There was significant better efficacy (p=0.001) in cases that had pleural effusion less than 1 liter at presentation where it was seen in 14 (63.64%) of cases as compared to 12 (31.58%) cases that had effusion less than 1 liter. There was no significant difference in terms of duration of pleural effusion with p=0.21. Conclusion: Doxycycline is efficacious in almost half of the cases and it is significantly better in cases that had effusion less than 1 liter.