This is Dr Basu, experienced Internal Medicine Specialist.
I am here to address your concerns and provide great service.
Symbicort contains a strong long acting steroid called budesonide.
This can weaken your immune system on long term use increasing the risk of infections.
Hence, you should discontinue symbicort for now.
Spiriva alone should be adequate.
If needed a long acting beta agonist like formoterol can be added with spiriva.
You should be treated with oral antifungal fluconazole 200 mg daily for 10 days.
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