OCCURRENCE OF ORAL CANDIDIASIS AMONG BRONCHIAL ASTHMA PATIENTS ON INHALED CORTICOSTEROIDS

Abstract

Introduction: Asthma is a heterogeneous disease, usually characterized by chronic airway inflamation.¹ Since airway inflammation was identified as the major pathologic condition in bronchial asthma, inhaled steroids have played a central role in asthma treatment^.2 The use of steroids facilitates disease control in asthmatic patients, resulting in improved quality of life. The guidelines for the treatment of bronchial asthma worldwide recommend the use of inhaled corticosteroids although highly effective, may be associated with both systemic and local side effects. The most common local adverse effect of ICS is oral candidiasis. The study aimed to ascertain relationship between inhaled corticosteroids and occurrence of oral candidiasis among asthma patients.

Methodology: The present study was undertaken among 50 asthmatic patients selected randomly from those admitted in ward & attended OPD of Department of Pulmonary Medicine, C. U. Shah medical college & Hospital, Surendranagar, Gujarat. All patients were subjected to detailed history and throat examination was done at the same time; a quantitative fungal culture was performed by aseptically obtaining a retropharyngeal wall swab from the patients in our study.

Result: Among the 50 patients, 32 (64%) were female and 18 (36%) were male. Age is ranged from 16 to 61 years (Mean 40.2 years). In this study a significantly larger amount of Candida spp. was detected in 20% asthmatic patients treated with inhaled steroids. The frequency of oral candidiasis was found to be higher in asthmatic patients using rota caps containing budesonide and formoterol via DPI and not rinsing mouth after taking ICS.

Conclusion: Occurrence of oral candidiasis is common in patients using inhaled corticosteroids in asthma. Although not life-threatening, these local side effects are clinically significant and stress the need for patient education and inhalation instruction.