Oral Medicine: The Awareness of Patients Using Steroid Inhalers on the Increased Risk of Oral Candidosis: A Service Evaluation
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 5
Abstract
Objective: To perform an evaluation of the current practice of informing patients on steroid inhalers of the increased risk of oral candidosis (thrush) as a side effect of using the inhaler. Method: This is a service evaluation in the form of a survey distributed to patients attending the respiratory medicine outpatient clinic at the Manchester Royal Infirmary (MRI). Results: The evaluation shows that the majority of patients are not informed of the risk associated with commonly prescribed steroid inhalers, and they feel that it is the responsibility of the doctors to warn them about this side effect. Very few patients received advice from their dentist on this matter. Conclusion: All healthcare professionals are responsible for the well-being of their patients. Dentist should play active role in advising patients on the oral side effects associated with the use of steroid inhalers. To perform an evaluation of the current practice of informing patients on steroid inhalers of the increased risk of oral candidosis as a side effect of using the inhaler. Asthma and Chronic Obstructive Pulmonary Disease (COPD) are common respiratory diseases affecting 5.4 and 3.2 million people of the UK population, respectively [1,2]. One of the treatments used for these conditions is steroid inhalers [3]. Steroid inhalers suppress the inflammatory reaction in the lung, which reduces the airway hyper responsiveness to allergens and irritants [3,4]. In 2014, 19.4 million steroid inhalers were dispensed in the community [5]. However, a prominent side effect of this intervention is the local suppression of the immune system, a phenomenon which could result in fungal infection [6-8]. A clinical trial comparing patients on steroid inhalers, nonsteroid inhalers and healthy subjects found that using steroid inhalers has a statistically significant effect on the count of oral Candida albican [9]. This was greater and dose-dependent in patients on fluticasone in contrast to those using beclomethasone [9,10]. However, a previous study found no correlation between the type of inhaler or the dose [7]. The risk increases with the concomitant use of broad-spectrum antibiotics, oral steroids and in diabetics [10]. A high C.albicans count increases the risk of oral candidosis, and once candidosis is established, antifungal treatment should be commenced.
Authors and Affiliations
Saleh Nasser Aldallal, Christopher Hardy
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