Abstract:

Objective  To systemically summarize clinical studies on prevention and treatment of oral candidiasis relevant to inhaled corticosteroids (ICS) based on Chinese population. Methods  Clinical studies on prevention and treatment of oral candidiasis relevant to ICS based on Chinese population were retrieved from Wanfang periodical databases, China National Knowledge Infrastructure, VIP Journal Integration Platform, Medline and Cochrane databases. The meta analysis was performed to combine studies of the same kind. Results  A total of 19 papers were included. Compared with conservative methods, active prevention significantly decreased the incidence of oral candidiasis of the patients who inhaled corticosteroids and the relative risk (RR) was 0.221 (P<0.001). Compared with normal saline or boiled water, performing mouth wash or oral care with sodium bicarbonate or drugs significantly decreased the incidence of oral candidiasis and the detection rate of Candida albicans in oropharynx for the patients who inhaled corticosteroids. The RR of the incidence was 0.180 (P<0.001) and the RR of the detection rate was 0.157 (P<0.001). Mouth washing or oral care with sodium bicarbonate solution, compound preparation of ketoconazole, or compound vitamin B12 solution spray were all effective for treating patients with oral candidiasis relevant to ICS. Conclusion  Patients should wash their mouths 2-3 times with sodium bicarbonate solution or perform oral care immediately after inhalation of corticosteroids to reduce the incidence of oral candidiasis. The nystatin solution can be used if necessary. Medical staff should supervise patients to wash their months if possible.

Key words: inhaled corticosteroids, oral candidiasis, adverse effect, mouth wash, oral care, sodium bicarbonate, nystatin