In children, the regular use of inhaled corticosteroids (ICS) was linked to a significant increase in the risk for oropharyngeal colonization by Staphylococcus pneumonia, according to researchers from Federal University of Rio Grande in Brazil.

“Given that naso-oropharyngeal colonization is an obligatory first step for S. pneumonia infections, the findings of this study may provide some clues about a possible link between use of ICS and risk of pneumococcal respiratory infections in children with persistent asthma,” the authors wrote.

Investigators examined oropharyngeal samples from 192 children with asthma, 96 of whom had been taking daily ICS for at least 30 days (average daily dose of beclomethasone 400 µg or equivalent). The remaining 96 children had no exposure to the medication.

In children taking ICS, the prevalence of S. pneumonia was 27.1%, compared to 8.3% in the group not exposed. After accounting for factors such as age, gender, number of siblings, day-care/school attendance, concomitant use of intranasal steroids, vaccination against S. pneumonia, antibiotic use in the last 3 months, and hospitalization in the last 6 months, the team found that regular ICS use was a significant independent predictor of oropharyngeal S. pneumonia colonization, at an adjusted prevalence ratio of 3.75.

“Further larger prospective studies are needed to better define the relationship between ICS therapy, oropharyngeal colonization by potential respiratory pathogens and clinical outcomes of these patients,” the authors concluded. “The influence of doses of ICS, duration of treatment, type of ICS and type of delivery device is also needed to be investigated.”