Comparison of the effects of doxycycline and povidone iodine in treatment of pleural effusion; an open label randomized clinical trial

Abstract

Introduction: Doxycycline is commonly used in treating pleural effusion. Povidone-iodine is another agent that has been used for treating pleural effusion. Objectives: We aimed to compare the effects of doxycycline and povidone iodine in treating pleural effusion. Patients and Methods: Forty-one patients with pleural effusion were enrolled and randomly divided into two groups. After insertion of the chest tube, pleurodesis was performed in the first group with povidone iodine and doxycycline in the second group. The chest tube clamped and opened one hour later. Then, connected to the suction through a double chest bottle. By decreasing of drainage to less than 50 cc per day, the chest tube was removed and the patients were evaluated three days later for pain, fever, empyema, recurrent effusion and long-term side effects at 7th, 30th, 60th and 90th day. Results: The pain intensity was not different between two groups (P > 0.05). None of the patients had empyema and other side effects including hemothorax or pneumothorax were not seen too. In a 90-day follow-up, 47.6% of doxycycline recipients and 25% of povidone iodine recipients experienced the recurrent effusion (P=0.133). Three patients had fever (one on the first day and two on the second day) in the doxycycline group, while fever was not observed in povidone iodine recipients. The cost of treatment in both groups was almost the same. Conclusion: Side effects of pleurodesis include pain, fever, recurrent effusion, cost in the two groups is almost equal, and both agents can be used as an effective drug for treating pleural effusion. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT2015052918168N3; https://en.irct.ir/trial/16560, ethical code; IR.SEMUMS.REC.1394.91).