Esophageal Candidiasis as a Complication of Inhaled Corticosteroids

Simon, Michael R.; Houser, William L; Smith, Kurtis A; Long, Patrick M.

doi:10.1016/s1081-1206(10)63024-4

Cited by 53 publications

(33 citation statements)

References 32 publications

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“…Las dependientes del huésped, como son: las edades extremas, la alteración de la función fagocítica (ya sea cualitativa o cuantitativa), la presencia de diversas patologías (diabetes mellitus, insuficiencia renal o hepática, neoplasias y algunas enfermedades endocrinológicas), también infección por virus de inmunodeficiencia humana (VIH) y condiciones que alteran la integridad de las mucosas: quimio o radioterapia, trauma o cirugía de gran envergadura, 2. Factores exógenos como uso crónico de esteroides orales o inhalatorios, el uso prolongado de antimicrobianos de amplio espectro y la administración de inmunosupresores 1,[3][4][5] .…”

Section: N V E S T I G a C I ó Nunclassified

Candidiasis esofágica en pacientes inmunocompetentes: Estudio clínico e inmunológico

et al. 2004

Rev. méd. Chile

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Section: N V E S T I G a C I ó Nunclassified

Candidiasis esofágica en pacientes inmunocompetentes: Estudio clínico e inmunológico

et al. 2004

Rev. méd. Chile

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“…The mouth washing procedure utilized seems to be important, as candidiasis has been reported by patients who washed their mouth after inahalation. 1) In our previous study, mouth washing with water removed residual drugs in the mouth. However, water might not reach around the pharynx easily, depending on the mouth washing procedure employed.…”

mentioning

confidence: 97%

Kinetic Analysis of Effects of Mouth Washing on Removal of Drug Residues Following Inhalation of Fluticasone Propionate Dry Powder

Yokoyama

Yamamura

Ozeki

et al. 2007

Biological & Pharmaceutical Bulletin

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Inhaled corticosteroids are widely used for treatment of asthma, though local adverse effects, such as candidiasis and hoarseness, are often seen in patients treated with those drugs. Therefore, the Packaging Inserts enclosed with such medications recommend mouth washing after inhalation for prevention of local adverse effects. In spite of that recommendation, candidiasis has been reported by patients who washed their mouth after inhalation.1) Therefore, we carried out a series of studies to investigate the influence of different methods of mouth washing on the removal rates of inhaled corticosteroids. More than 90% of the drug was recovered by washing mouth twice, when the mouth washing procedure was gargling and rinsing for 5 s each.2) However, since no significant differences were observed among 3 methods tested in a previous study, we could not conclude which was most effective. On the other hand, a relationship was observed between the amount of drug residue removed by mouth washing and the number of times of mouth washing was employed in 2 phases. 3,4)Based on those results, we speculated that drug residue remained in different amounts in easy and difficult to remove areas following mouth washing. In the present study, we investigated the differences in removal efficiency of drug residues from both easy and difficult to remove areas using 3 different methods of mouth washing; gargling and rinsing in combination, rinsing alone, and gargling alone, using a compartment model. MATERIALS AND METHODS Compartment Model for Analysis of Removal Efficiency of Drug Residues by Mouth WashingFlutide ® (FP-DPI) 50, 100, and 200 Rotadisk ® dosages were used in the present study. In addition, we employed our previously reported experimental data in the analysis, in which 3 healthy volunteers (2 males, 1 female; mean age 38.3Ϯ9.3 years old, range 28-45 years) participated.3) In the present experiment, mouth washing was started immediately following sprinkling directly in the mouth or inhalation of 1 blister, and consisted of gargling and rinsing with water for 5 s each, then the procedures were repeated 5 times. The total volume of water used for each mouth washing was 100 ml, which was divided into 5 aliquots of 20 ml each. We also developed a compartment model, in which inhaled FP-DPI residue was distributed into 2 different areas, one from which the drug was easily removed and the other from which it was difficult to remove by mouth washing. The equations used for the model were as follows:In those, X 1 and X 2 represent the amount of drugs in areas from which drugs are easily removed and difficult to remove, respectively. X 0 , F, T, and n represent the medication dose, ratio of amount of dose removed by mouth washing to medication dose, ratio of amount of dose removed from the difficult to remove area by mouth washing to total amount of dose removed by mouth washing, and the number of times of mouth washing, respectively. Further, k 1 and k 2 represent the constants of removal efficiency of X 1 and X 2 , respectively....

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“…C. albicans is the most virulent and common causative organism in CE. Other species, including C. tropicalis, C. krusei, and C. stellatoidea, have also been isolated (11). C. glabrata currently ranks second or third as the causative agent of superficial (oral, esophageal, vaginal, or urinary) or systemic Candida infections, which are often nosocomial (9).…”

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confidence: 99%

Candida Glabrata Esophagitis: new case reports and management

Macêdo¹,

Silva²,

Farias³

et al. 2008

Braz. J. Microbiol.

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Candida esophagitis (CE) is a common opportunistic infection in the immunocompromised host. C. glabrata is rarely cited as agent of CE and has been underestimated due to lack of proper identification. In this study, two cases of C. glabrata esophagitis in AIDS and chagasic patients are reported. Diagnosis of Candida species should be considered an important key for the ideal choice of antifungal therapy against this mycosis.

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Esophageal Candidiasis as a Complication of Inhaled Corticosteroids

Cited by 53 publications

References 32 publications

Candidiasis esofágica en pacientes inmunocompetentes: Estudio clínico e inmunológico

Candidiasis esofágica en pacientes inmunocompetentes: Estudio clínico e inmunológico

Kinetic Analysis of Effects of Mouth Washing on Removal of Drug Residues Following Inhalation of Fluticasone Propionate Dry Powder

Candida Glabrata Esophagitis: new case reports and management

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