Effects of amphotericin B gargles on oral colonization of Candida albicansin asthmatic patients on steroid inhalation therapy

C. Fukushima et al., Effects of amphotericin B gargles on oral colonization of Candida albicansin asthmatic patients on steroid inhalation therapy, RESPIRATION, 68(5), 2001, pp. 465-470
Citations number
Categorie Soggetti
Cardiovascular & Respiratory Systems","da verificare
Journal title
ISSN journal
0025-7931 → ACNP
Year of publication
465 - 470
SICI code
Background: Early use of inhaled steroids is recommended for bronchial asth ma. The side effects are rare, but oral discomfort and candidiasis are clin ically important complications. Most previous studies reported that the use of spacer and water gargling was necessary to prevent oral complications. However, in some patients, this may fail to prevent such complications. Obj ective: To compare the effects of water gargling with those of amphotericin B, in the prevention of oral complications in asthmatics using inhaled ste roids. Methods: Pharyngeal swab samples were obtained aseptically from the posterior pharyngeal wall of 128 asthmatics who have been using inhaled ste roids (beclomethasone dipropionate) for more than 1 year. The amount of Can dida albicans in cultured swabs was evaluated based on the following criter ia: oral symptoms, method of gargling, dose of inhaled steroids, type of sp acer and serum cortisol level. Results: The number of isolated C. albicans was significantly higher in asthmatics with oral symptoms than in those fre e of symptoms. It was also significantly higher in patients who gargled wit h water or 1,000 times dilution than in those who gargled with 100 or 50 ti mes dilutions of amphotericin B. Moreover, it was significantly higher in p atients with low levels of serum cortisol than in those with normal serum c ortisol. Conclusion: We demonstrated that at least in a subgroup of asthmat ics using steroid inhalers, gargling with water or even weak concentrations of amphotericin B does not prevent colonization of the throat with C. albi cans. This group at high risk of developing oral candidiasis should gargle with amphotericin B at concentrations higher than 100 times dilution that c an prevent clinically detectable oral candidiasis. Copyright (C) 2001 S. Ka rger AG, Basel.