Efficacy and safety of erythromycin as sclerosing agent in patients with recurrent malignant pleural effusion.
OBJECTIVE
The aim of pleurodesis in malignant pleural effusions is to prevent reaccumulation of the fluid, symptoms, and avoid the need for repeated hospitalization for thoracentesis. The purpose of this study was to evaluate the efficacy and safety of erythromycin as a pleural sclerosing agent.


METHODS
Over a 2-year period, 34 patients with a symptomatic, recurrent, malignant pleural effusion who referred for chest tube drainage and pleurodesis were included. They had not received prior intrapleural therapy and had predicted survival of at least 1 month. All underwent pleural drainage and chemical pleurodesis with erythromycin. Complications and response to pleurodesis, according to clinical and radiographic criteria after 90 days, were recorded.


RESULTS
The overall response was 88.2%. Complete response (no reaccumulation of pleural fluid after 90 days) was observed in 27 patients (79.4%). Partial response (reaccumulation of fluid but without symptoms, not requiring drainage) was observed in 3 (8.8%). No response (symptomatic reaccumulation of fluid that required drainage) was observed in 4 (11.8%). All patients experienced pleurodynia that was treated with administration of paracetamol and/or dextropropoxyphene. Sinus tachycardia and concurrent mild systemic hypertension were observed 2 and 4 hours after pleurodesis. Both of them were attributed to pleurodynia as there was remission with analgesics.


CONCLUSIONS
This study suggests that erythromycin is effective and safe as a sclerosing agent for pleurodesis in patients with recurrent malignant pleural effusions.
Pulmonary Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece.
George
G
Balassoulis
Lazaros
L
Sichletidis
Dionisios
D
Spyratos
Diamantis
D
Chloros
Kostas
K
Zarogoulidis
Theodoros
T
Kontakiotis
Vassilios
V
Bagalas
Kostas
K
Porpodis
Katerina
K
Manika
Dimitrios
D
Patakas
D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology / Q000628:therapy; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy; D018288:Carcinoma, Small Cell / Q000150:complications / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000473:pathology / Q000628:therapy; D004322:Drainage; D004917:Erythromycin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy; D008297:Male; D016066:Pleural Effusion, Malignant / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D018700:Pleurodesis; D012008:Recurrence; D012449:Safety; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D012597:Sclerosing Solutions; D004917:Erythromycin