Inhalational and topical steroids, and oral candidosis: a mini review

Abstract

Candidosis is by far the commonest oral fungal infection in man and could manifest as an adverse effect of drug therapy such as inhaled or topically applied corticosteroids. Due to the anti-inflammatory and immunosuppressive effect steroids are used in the management of bronchial asthma and oral mucosal diseases. In this mini review we discuss the clinical and laboratory findings on the relationship between steroid inhalers, other topical steroids and oral candidosis, possible mechanisms of pathogenicity following such therapy as well as the precautions that could be taken to minimize this adverse side effect.

Direct effects of non-antifungal agents used in cancer chemotherapy and organ transplantation on the development and virulence ofCandidaandAspergillusspecies

“…Early observations that treatment with glucocorticoids increased the C. albicans burden in the gastrointestinal tract and frequency of fungal translocation from the gastrointestinal tract to the bloodstream in mice and rats, 49,50 raised the possibility that steroids can augment the growth rate of Candida spp. 5,51 Their direct effects on Candida growth per se however, remain undetermined.…”

Influence of Mouth Washing Procedures on the Removal of Drug Residues Following Inhalation of Corticosteroids

“…In the case of inhaled administration, the lesions are generally localized in areas where the aerosol is deposited, and the degree of candidiasis is probably related to dosage and frequency of therapy. 10) We previously reported findings for a patient who washed their mouth with a lag time of 15 min after inhalation and developed oral candidosis. 13) For the prevention of dysphonia, mouth washing immediately after inhaling the drug is recommended to minimize local adsorption.…”

“…Patients with asthma that use inhaled corticosteroids range widely in age from children to adults, and local adverse effects from inhaled corticosteroid are common findings in all ages. 10) Thus, the age range of the present patients was considered to be appropriate. The objectives and protocol were fully explained to each, and signed informed consent was obtained from all subjects prior to beginning the study.…”

Effects of Mouth Washing Procedures on Removal of Budesonide Inhaled by Using Turbuhaler

“…Patients with asthma that use inhaled corticosteroids range widely in age from children to adults, and local adverse eŠects from inhaled corticosteroid are commonˆndings in all ages. 5) Thus, the age range of the present volunteers was considered to be appropriate. The objectives and protocol were fully explained to each, and signed informed consent was obtained from all subjects prior to beginning the study.…”