Inhaled beclomethasone and oral candidiasis

Area of Science:

• Pediatric Pulmonology
• Medical Mycology
• Pharmacology

Background:

• Asthma is a common chronic respiratory disease in children.
• Inhaled corticosteroids (ICS) are the mainstay of asthma management.
• Candida colonization of the oropharynx is a potential side effect of ICS therapy.

Purpose of the Study:

• To investigate the incidence of Candida colonization in the oropharynx of children with asthma.
• To determine the relationship between ICS use, dosage, and Candida colonization.
• To assess the association of Candida colonization with symptoms like sore throat and hoarse voice.

Main Methods:

• Throat swabs were collected from 229 children (aged 6-15 years) attending an asthma clinic.
• Children were categorized into three groups based on ICS (beclomethasone) dosage: no steroids, <500 mcg/day, and ≥500 mcg/day.
• Data on sore throat, hoarse voice, and inhaler type were collected and analyzed.

Main Results:

• Candida colonization was more frequent in children using ICS compared to non-users.
• Higher ICS dosage did not correlate with increased Candida colonization.
• No significant association was found between Candida colonization and sore throat or hoarse voice.
• Only one case of clinical thrush was observed.

Conclusions:

• Inhaled beclomethasone increases Candida colonization in pediatric asthma patients.
• The risk of Candida colonization does not escalate with higher ICS doses.
• ICS therapy in children is not associated with increased prevalence of sore throat, hoarse voice, or clinical thrush.