Have you come across asthma patients, or COPD patients who keep complaining about oral fungal infections?
Patients suffering from asthma, COPD or HIV are commonly prescribed inhaled corticosteroids (ICSs); however, long term usage of ICSs causes local immunosuppression in oral cavity which in turn results in development of oropharyngeal candidiasis, a fungal infection primarily caused by Candida albicans. Key risk factors include high ICS doses, poor oral hygiene and improper use of inhalers.
I remember a patient frequently complaining of oral thrush, and that would result in additional medications to treat the same. This caused a loop of treating side effects of standard treatment protocols. However, prevention plays a crucial role in overcoming the side effects of prolonged use of ICSs particularly by focusing on patient education.
Some of the simple yet effective preventive measures include:
- Oral Hygiene: Remember to instruct the patients to rinse the mouth properly, ensure that the patient gurgles and swishes the water 2 to 3 times after using inhalers.
- Cleaning the Equipments: Instruct the patient to clean the Equipments regularly be it the nebulizer, or simply the pump.
- Tooth Brush: Instruct patients to maintain oral hygiene by brushing twice daily using appropriate toothpaste.
This list is not exhaustive, please check this link for more information Non-Pharmacological Interventions to Prevent Oropharyngeal Candidiasis in Patients Using Inhaled Corticosteroids: A Narrative Review - PMC Non-Pharmacological Interventions to Prevent Oropharyngeal Candidiasis in Patients Using Inhaled Corticosteroids: A Narrative Review - PMC
Have you encountered a patient complaining of oral thrush or maybe someone you know struggles from this issue? What are your thoughts about it and what more can be done by adopting preventive measures.
