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Candida - oral - Management
Basis for recommendation
Inhaled corticosteroids and oral candidiasis
- Deposition of inhaled corticosteroids in the mouth is thought to have a localized immunosuppressive effect on the mucosa, leading to an increased risk of oral candidiasis.
- A systematic review and meta-analysis of randomized controlled trials (RCTs) found that inhaled corticosteroids significantly increased the incidence of oral candidal infection, dysphonia, and pharyngitis compared with placebo at all doses studied, and regardless of the device used [Rachelefsky et al, 2007].
Management of inhaled corticosteroids
- The recommendation to use good inhaler technique and wash the mouth after use aims to minimize the exposure of corticosteroid on the oral mucosa [Rachelefsky et al, 2007].
- A large-volume spacer device reduces oropharyngeal deposition by filtering out larger particles, and is useful for use with pressurized metered-dose inhalers [DTB, 2000; RPSGB, 2006].
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