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Risk factors for esophageal candidiasis.

A Chocarro Martínez1, F Galindo Tobal, G Ruiz-Irastorza

  • 1Department of Internal Medicine, Hospital Virgen de la Concha, Zamora, Spain. achocarrom@medynet.com

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|April 4, 2000
PubMed
Summary

Gastric acid inhibitors like omeprazole, along with antibiotics and steroids, are linked to increased risk of Candida esophagitis in patients with chronic diseases. This suggests omeprazole may promote esophageal candidiasis development.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Pharmacology

Background:

  • The role of gastric acid inhibitors in predisposing individuals to Candida esophagitis remains unclear.
  • Candida esophagitis is a significant opportunistic infection, particularly in immunocompromised or debilitated patients.

Purpose of the Study:

  • To investigate the potential role of gastric acid inhibitors, specifically omeprazole, as predisposing factors for Candida esophagitis.
  • To identify risk factors associated with the development of esophageal candidiasis in human immunodeficiency virus (HIV)-negative patients.

Main Methods:

  • A retrospective case-control study was conducted involving HIV-negative patients diagnosed with esophageal candidiasis between January 1991 and December 1997.
  • Diagnosis of esophageal candidiasis was confirmed through endoscopic and histological examination.

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  • Multivariate analysis was employed to assess the association between various factors (neoplasms, antibiotic, steroid, and omeprazole therapy) and the occurrence of esophageal candidiasis.

    • Main Results:

    • Fifty-one patients were diagnosed with esophageal candidiasis. A significant proportion had pre-existing chronic diseases (48 patients) or had received prior treatments with antibiotics (20), steroids (13), or omeprazole (14).
    • Multivariate analysis revealed significant associations between esophageal candidiasis and neoplasm (OR, 5.50), antibiotic therapy (OR, 11.97), steroid therapy (OR, 35.52), and omeprazole therapy (OR, 18.23).
    • The odds of developing Candida esophagitis were substantially increased with prior exposure to antibiotics, steroids, and particularly omeprazole.

    Conclusions:

    • Candida esophagitis is more likely to occur in patients with chronic diseases who have been treated with antibiotics, steroids, or omeprazole.
    • The findings strongly support the hypothesis that omeprazole treatment contributes to the development of esophageal candidiasis.
    • These results highlight the importance of considering medication history, including gastric acid inhibitors, in the management of patients with suspected Candida esophagitis.