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Inhaled corticosteroid oral candidiasis — GPhC CRA MCQ

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ModerateRespiratory TherapeuticsInhaled corticosteroid oral candidiasisGPhC CRA

A 65-year-old man using high-dose inhaled fluticasone for COPD has recurrent oral soreness and white plaques that wipe off. He does not use a spacer and rarely rinses after inhalation. What would you advise the patient?

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Correct answer: C — Advise mouth rinsing, technique review and assessment for oral candidiasis treatment

Inhaled corticosteroids can cause oral candidiasis, especially with poor technique and no mouth rinsing. Technique review, spacer consideration where appropriate, and rinsing after inhalation reduce recurrence. Existing thrush may require antifungal treatment after assessment. Abruptly stopping COPD therapy without review may worsen symptoms.

Reference: BNF; NICE CKS