This is common with GERDS and
syndromes. Normally the esophagus and
trachea are very resistant to infection If there is acid refluc, the situation changes. The acid destroys the barrier to bacterial infection, and together with the prednisone the patient becomes prone to a sore throat, and infection which may rapidly progress to the lung.
Thus, the drill is, when on high-dose oral predisone, avoid esophageal acid erosion. I don't know why this information is not widely known.