Risk factors for esophageal candidiasis

The role of gastric acid inhibitors as predisposing factors for Candida eso phagitis is unknown. A retrospective case-control study of esophageal candi diasis was conducted in human immunodeficiency virus (HIV)-negative patient s diagnosed from January 1991 to December 1997. The diagnosis of esophageal candidiasis was always made on the basis of endoscopic and histological cr iteria. Fifty-one patients were diagnosed with esophageal candidiasis, 15 o f whom had esophageal complaints and 48 of whom suffered from another previ ous chronic disease (17 had cancer). In addition, 20 patients had previousl y been treated with antibiotics, 13 with steroids and 14 with omeprazole. I n the multivariate analysis, neoplasm (odds ratio, 5.50; 95% confidence int erval, 1.94-15.56) and therapy with antibiotics (odds ratio, 11.97; 95% con fidence interval, 3.82-37.45), steroids (odds ratio, 35.52; 95% confidence interval, 3.90-324.01) or omeprazole (odds ratio, 18.23; 95% confidence int erval, 4.67-71.03) were all associated with esophageal candidiasis. These d ata suggest that Candida esophagitis tends to occur in patients with chroni c diseases, most of whom have been previously treated with antibiotics, ste roids or omeprazole. The findings support the hypothesis that treatment wit h omeprazole favors the development of esophageal candidiasis.