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Inhaled corticosteroid oral candidiasis — GPhC CRA MCQ

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EasyInfection TherapeuticsInhaled corticosteroid oral candidiasisGPhC CRA

A 22-year-old woman presents to the pharmacy requesting treatment for oral thrush. She has been using beclometasone 200 micrograms inhaler twice daily for asthma. What is the most appropriate initial recommendation?

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Correct answer: E — Advise her to rinse her mouth with water and spit out after each inhaler use, and supply miconazole oral gel

Oral candidiasis is a well-recognised side effect of inhaled corticosteroids. The most appropriate management includes treating the current infection with miconazole oral gel and counselling on preventive measures, particularly rinsing the mouth with water after each inhaler use and spitting out. The inhaler should not be stopped. A spacer device can also help reduce oropharyngeal deposition. Urgent referral is not needed as the cause is clear.

Reference: BNF; NICE CKS Oral Candidiasis