title: Comparison of side effects of oxytetracycline and talc pleurodesis: an experimental study.
abstract: BACKGROUND
  Chemical pleurodesis is widely recommended in the treatment of refractory pleural effusion or pulmonary air leak of different etiologies. Although several agents have been used, many questions have remained unanswered about their toxicity. Talc is the most commonly used agent for the treatment, with rare, serious complications reported. Oxytetracycline pleurodesis in clinical practice has been described in a few studies, but literature reveals no experimental studies using this agent. We performed a prospective, randomized, observer-blinded, controlled study to evaluate the changes in lung histology and systemic response to pleurodesis with oxytetracycline and talc in acute and subacute phases in a rat model.
  
  
  METHODS
  Forty-two male albino Wistar rats were divided into three groups and 3 subgroups with 7 animals in each. Group 1 was given oxytetracycline, 35 mg/kg; Group 2 was given talc slurry, 60 mg/kg in 0.5 mL saline solution, and Group 3 was given only 0.5 mL saline intrapleurally. In subgroups "a" the nimls were sacrificed at the postoperative 72nd hour and, in subgroups "b", on the postoperative day 7. The surfaces were graded by microscopic examination.
  
  
  RESULTS
  Oxytetracycline produced alveolar collapse, hemorrhage, edema, inflammation at the postoperative 72nd hour and hemorrhage on the postoperative day 7, while talc produced significant edema, inflammation, proliferation, fibrosis at the postoperative 72nd hour and hemorrhage, edema, inflammation, proliferation, and fibrosis on the postoperative day 7 (p < 0.0042). Talc produced significant edema compared to oxytetracycline on the postoperative day 7. On contralateral side, oxytetracycline and talc produced significant hemorrhage on the postoperative day 7 (p < 0.0042).
  
  
  CONCLUSIONS
  Both agents were shown to produce pulmonary lesions. In acute phase, the pulmonary side effects of oxytetracycline were more pronounced, whereas the side effects of talc were prolonged to subacute phase. We propose that the occasional side effects in humans may be related to these changes as were observed in our rat model, and like talc, oxytetracycline must be used cautiously in patients with limited respiratory function.
authors.affiliation: Department of Thoracic Surgery, Kırıkkale University, School of Medicine, Kırıkkale, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Gözübüyük
authors.forename: Berkant
authors.initials: B
authors.lastname: Ozpolat
authors.forename: Ali Fuat
authors.initials: AF
authors.lastname: Ciçek
authors.forename: Hasan
authors.initials: H
authors.lastname: Caylak
authors.forename: Orhan
authors.initials: O
authors.lastname: Yücel
authors.forename: Kuthan
authors.initials: K
authors.lastname: Kavaklı
authors.forename: Sedat
authors.initials: S
authors.lastname: Gürkök
authors.forename: Onur
authors.initials: O
authors.lastname: Genç
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D051520:Antiperspirants / Q000009:adverse effects*; D008168:Lung / Q000187:drug effects* / Q000473:pathology; D008297:Male; D010118:Oxytetracycline / Q000008:administration & dosage / Q000009:adverse effects*; D018700:Pleurodesis / Q000009:adverse effects*; D051381:Rats; D017208:Rats, Wistar; D013627:Talc / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D051520:Antiperspirants; D013627:Talc; D010118:Oxytetracycline