The frequency and risk factors for oropharyngeal candidiasis in adult asthma patients using inhaled corticosteroids

Abstract

OBJECTIVES: Worldwide, asthma is a major health problem and inhaled corticosteroids (ICS) are the mainstay of asthma treatment. High-dose and long-term use of ICS can result in some side effects. The present study aimed to determine the frequency of oral and systemic candidiasis infections in adult asthma patients using ICS, and to identify possible risk factors. MATERIAL AND METHODS: This study included 186 randomly selected adult asthma patients that presented to allergy clinic between May 2011 and September 2012. RESULTS: Among the patients, 147 (79%) were female. The lifelong incidence of oral candidiasis was 19.4% (n=36), whereas 5.38% (n=10) of the patients already had it by the time of the study. The lifelong incidence of any fungal infection was 59.7% (n=111). There weren’t any significant differences in gender, age, age at onset of asthma, oral hygiene, atopy, or comorbid diseases between the oropharyngeal candidiasis (OPC)-positive and -negative groups. A history of persistent rhinitis, use of a leukotriene receptor antagonist together with ICS, and use of ciclesonide as an ICS were associated with a higher incidence of OPC. CONCLUSION: In the present study the incidence of OPC in adult asthma patients was quite high, but no definitive risk factors were identified. Further studies are needed to distinguish these individual differences.