Frequency of Oral Candidiasis in Asthma Patients using Inhaled Corticosteriods by Different Inhaler Devices

Abstract

Objective:In this study, we aimed to compare the frequency of oralcandidiasis in asthma patients using inhaled corticosteroids by metered doseinhalers via spacer and Rota caps via Revolizer.Methods:Asthma patients using inhaled corticosteroids by MDI via a spacer device or Rota caps via Revolizer for at least 2 months presenting to consultant chest clinics were divided into two groups. Group A were patients that used inhaled steroids by MDI via spacer and Group B had patients who used Rota caps via Revolizer. The throat was checked for any oral candidiasis by attending physician in all patients and detailed examination of throat performed by ENT consultant in patients who reported discomfort in throat or dysphonia.Results: Out of total 150patients (group A: 66 and group B: 84) included in the study, 82 (55 %) were females and 68 (45%) were males. Age ranged from 13 to 78 years (Mean 44.58). 106 patients (71%) included in the study had moderate asthma while 54 patients (29%) had severe asthma. Only 39 patients (26%) reported any discomfort in the throat while 111 patients (74%) had no such complaints. Frequency of oral candidiasis was 14 (16.7%) in Group B patients using Rotacaps containing Budesonide 400 mcg and Formeterol Fumerate 6 mcg via Revolizer and it was 4 (6.1%) in Group A patients who used MDI containing Fluticasone propionate 250 mcg + Salmeterol xinafoate 25 with spacer device. It was higher in Group B patients as compared to Group A (p < 0.05). The frequency of oral candidiasis was also higher in patients > 50 years of age as compared to patients less than 50 years of age.Conclusion: This study showed a higher rate of oral candidiasis in patients using Rota caps containing Budesonide and formoterol by Revolizer as compared to MDI with spacer.