Occurrence and risk factors of oral candidiasis treated with oral antifungals in seniors using inhaled steroids

Oral candidiasis (OC) is a frequent side effect of inhaled corticosteroids (iCSTs). This study estimated occurrence and significance of risk factors o f OC treated with antifungals in users of iCSTs under conditions of normal use. This retrospective analysis used data drawn from drug insurance plan r ecords in Quebec, Canada. The sample contained 27,000 seniors using anti-as thma medications during 1990. Three years of data (1989-1991) were searched for use of oral antifungals concurrent with exposure to iCSTs. A case-cont rol study examined factors leading to increased probability of first incide nce of OC in new users of iCSTs. Three-year occurrence for OC was 7%. Incre ased risk for a first occurrence of OC was significantly associated with hi gher doses of iCST, increased length of iCST exposure, use of antibiotics, use of oral steroids, having three or more prescribers, a history of use of both high and low strengths of iCST, and concurrent use of oral steroids a nd diabetes medications. The occurrence of OC is relatively high. Knowledge of factors leading to increased risk could facilitate the targetting of pa tients who need timely intervention, under conditions of normal use. (C) 20 00 Elsevier Science Inc. All rights reserved.