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ICS oral candidiasis — GPhC CRA MCQ

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ModerateRespiratory TherapeuticsICS oral candidiasisGPhC CRA

A 41-year-old man taking high-dose inhaled corticosteroid for asthma reports hoarseness and white plaques in his mouth. He rarely uses a spacer and does not rinse after inhalation. What is the most appropriate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Advise mouth rinsing and spacer use, and refer for antifungal treatment if candidiasis is suspected

Inhaled corticosteroids can cause local candidiasis and dysphonia, particularly with poor technique. Rinsing the mouth, spitting after use and using a spacer with pMDIs can reduce local deposition. Suspected oral candidiasis may need appropriate antifungal treatment. Stopping preventer therapy abruptly could worsen asthma control.

Reference: BNF; NICE CKS Asthma