Medical Edge Newspaper Column

Connections Between Antibiotic Use and Throat Infections

Oct. 28, 2007
Dear Mayo Clinic:
I'm in my mid-40s and three years ago I developed a yeast infection in my throat, which the doctor attributed to antibiotic use. I now get this type of infection every time I'm placed on antibiotics. I have been HIV tested and the results are negative. What type of treatment should I seek to strengthen my immune system?

Answer:
The condition you describe sounds like oral thrush, an infection caused by the fungus Candida albicans and often called a yeast infection. This fungus can proliferate when antibiotics kill the normal bacteria in our throats. In the allergy clinic, we regularly see oral thrush in patients who use corticosteroid inhalers to treat asthma. Thrush also may occur after steroids are taken by mouth or by injection, and in older adults and people with compromised immune systems.

Rather than seeking to strengthen your immune system, it may be more effective to consider ways to decrease your use of antibiotics, as they may be triggering the fungal infection in your throat. If you haven't already done so, work with your doctor to determine why you take antibiotics. Conditions such as allergic rhinitis and viral infections may not require antibiotics.

Several medical conditions may increase your susceptibility to oral thrush. You mention that human immunodeficiency virus (HIV) has been ruled out, but another underlying medical condition — such as diabetes, cancer or a rare immunodeficiency disorder — could be the culprit. In addition, factors such as dentures, previous chemotherapy or head and neck radiation may predispose a person to developing oral thrush. If you have any of these risk factors, talk to your doctor about ways to reduce your risk and help prevent the infection. For example, if you use inhaled steroids for asthma, after each medication use rinse your mouth thoroughly with water and spit it out.

To return to your original question: there's no proven safe and effective way to boost your immune system to fight this type of infection. Altering your body's entire immune system to combat oral thrush may be more than you really need and could be accompanied by unanticipated adverse side effects. Antifungal medications can usually control the condition. Although research hasn't shown conclusive evidence supporting their use, some reports suggest that eating unsweetened yogurt or taking acidophilus capsules or liquid may help restore your body's natural balance of bacteria, which may have been disturbed by antibiotic use.

— John Hagan, M.D., Allergic Diseases, Mayo Clinic, Rochester, Minn.