International Journal of Contemporary Medicine

Oral candidiasis associated with inhaled corticosteroid may be seen as a result of oral deposition of inhaled corticosteroid. It can be related to dosage, duration, drug and device used in inhalation of therapy.

To observe the incidence of oral candidiasis in patients diagnosed with stable obstructive airway disease treated with inhaled corticosteroids.

300 out patients were enrolled in the study. A retropharyngeal wall swab was taken aseptically for quantitative fungal culture in all enrolled patients after considering inclusion and exclusion criteria.

14(4.6%) patients were diagnosed of oral candidiasis out of the total patients in the study. Among these 11(78.5%) patients were on high dosage and 3(21.5%) patients were on moderate dosage of inhaled corticosteroids.

9(64.3%) patients were found to have oral candidiasis who were taking inhaled corticosteroid over 1 year and 5 (35.7%) patients had oral candidiasis who had less than 1 year of inhaled corticosteroid treatment.

Out of 14 patients with oral candidiasis 9 (64.29%) [DPI-6, MDI-2, MDI with spacer-1] patients were on fluticasone and 5 (35.71%) [DPI-3, MDI-2, MDI with spacer-0] patients on budesonide. Higher incidences were seen in patients using DPI as device of inhalation as compared to MDI plus MDI with spacer when paired to each of the device was compared among each other also.

Result of this study confirms that higher dosage of inhaled corticosteroid, longer duration, use of fluticasone compared to budesonide and DPI as route of inhalation, increases the risk of developing oral candidiasis. Incidence of oral candidiasis can be lowered if patients are counselled well by doctors for better treatment adherence. Hence patients, who are receiving inhaled corticosteroids, should be counselled for regular gargling, maintenance of oral hygiene and use of large volume spacers with MDI.