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Oral thrush from inhaled steroid — GPhC CRA MCQ

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EasyInfectionsOral thrush from inhaled steroidGPhC CRA

A 42-year-old woman using high-dose fluticasone inhaler reports creamy white patches on her tongue and soreness after recent antibiotics. She is not immunocompromised and can swallow. She admits she does not rinse after inhaler use. What is the most appropriate action?

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Correct answer: B — Recommend suitable antifungal treatment and reinforce inhaler mouth-rinsing

The presentation is compatible with oral candidiasis, with inhaled corticosteroid use and recent antibiotics as risk factors. Suitable antifungal treatment may be appropriate depending on pharmacy service scope and local protocols, alongside counselling on mouth-rinsing and inhaler technique. Stopping preventer therapy without review may destabilise asthma. Tetracycline is not appropriate for oral candidiasis.

Reference: NICE CKS Candida - oral; BNF