- Mild: Amoxicillin or Doxycycline
- Mod: Benzylpenicillin + Atypical cover: Doxy or Azithromycin (Tropical = Ceftriaxone + Gentamicin)
- Severe: Ceftriaxone + Azithromycin. (Consider Vancomycin if covering Staph, Tazocin if concern about G-ve, Tropical Merepenem or Tazocin and Azithromycin)
- Patients with a closed pneumothorax should not travel on commercial flights (with the exception of the very rare case of a loculated or chronic localised air collection which has been very carefully evaluated) (C).
- Patients who have had a pneumothorax must have a chest x- ray to confirm resolution before flight. Many would regard it as prudent for a further 7 days to elapse before embarking upon flight (C).
- In the case of a traumatic pneumothorax, the delay after full radiographic resolution should ideally be 2 weeks (D).
- A definitive surgical intervention undertaken via thoracotomy is likely to be entirely successful and patients should be allowed to fly once they have recovered from surgery. (D) A similar intervention undertaken by video- assisted thoracoscopic surgery is also expected to have a high success rate but is not definitive; these patients should be aware of a slight risk of recurrence (B).
- Patients having other forms of pleurodesis and those not undergoing pleurodesis after a pneumothorax are unlikely to have further episodes precipitated by flight, but spontaneous recurrence could have important consequences in the absence of prompt medical care. The risk of recurrence is higher in those with coexisting lung disease and does not fall significantly for at least 1year. Those not undergoing definitive surgery may therefore wish to consider alternative forms of transport (D).