プロピオン酸ベクロメタゾン吸入にて治療中の気管支ぜん息患者における咽頭カンジダの検出に関する検討

概要

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We investigated oropharyngeal candidiasis in patients with bronchial asthma treated with inhaled beclomethasone dipropionate (BDP). The detected rate of Candida in the oropharynx in these asthmatic patients was 33.3%, which was significantly higher than that in control subjects. This rate significantly depended on the frequency of the inhalation of the BDP (p <0.05), but there was no correlation with the inhalation dose per either time and day. The term of administration of the inhaled BDP tended to be longer in the Candida positive cases, and there was a significant correlation between the term of administration and the amount of Candida detected (r =-0.67, p <0.05). Although it is considered that gargling after inhalation and the use of spacers are effective in preventing oropharyngeal candidiasis, the detected rates of Candida were 33.3% in both patients who either gargled and used spacers and those who did not. The patients who understood the reason why the spacers and gargling were necessary accounted for just 85.2% of the total, in spite of the education efforts of the medical staff.In conclusion, a decrease in the number of inhalations of BDP per day may be effective in preventing oropharyngeal candidiasis, and various ways to increase the understanding of patients are needed for education pertaining to gargling after inhalation and the use of spacers.
特定非営利活動法人日本気管食道科学会の論文