Chest tube insertion (CTI) and connection to water seal system is a common treatment modality in the first episode of Primary Spontaneous Pneumothorax (PSP) patients . Routine antibiotic usage after the procedure is still discussed and is controversial. The aim of the study is to evaluate the results of our PSP patients whom did not receive antibiotic treatment after CTI.
Between 2004- 2008 there were 674 patients with diagnosis of pneumothorax in our clinic . Medical records are evaluated retrospectively. From this group 492 of them were classified as first episode of PSP. All the patients had CTI in the emergency room under local anesthesia, 26 of them had prolonged air leakage and planned for surgery of after 10. day of CTI. None of the patient had routine antibiotic treatment after CTI.
Patients had a mean age of 22.3 years (14–84), 457 (92.8%) were male 35 (7.2%) were female. Following CTI, 401 (81.5%) patients completed the treatment and were discharged from the hospital within 7 days. Sixtyfive (13.2%) patients discharged between days 7–10. The rest 26(5.2%) had prolonged airleakage and planned for surgical intervention, they had antibiotic prophylaxy before surgery. There were local induration on the site of CTI in 25 (5%) patients and 10 (2%) patients had fever lasting less than 24 hours without sign of any infection, 2 patients had limited seperation on the site of surgical intervention. They were all treated with simple medical approaches. There was no other morbidity.
According to our experience routine antibiotic usage after CTI in PSP patients is not sufficient .
This policy is cost-effective and prevents patients from undesired side effects also avoids development of strains of drug resistant bacteria.
Volkan Kara, No Financial Disclosure Information; No Product/Research Disclosure Information