500 mcg of
fluticasone , increases the likelihood
of pneumonia. The administration
of systemic (oral) corticosteroids is a known risk factor for tuberculosis (TB). It has been reported that high dose ICS is associated with the development of pulmonary TB in persons with COPD* For this reason, it has been recommended that every patient with COPD should undergo chest radiography, sputum acid-fast smear, and mycobacterial culture before receiving, as well as regularly during, HD ICS therapy.