Clinical Assistant Professor University of Iowa Stead Family Children's Hospital Iowa, Iowa, United States
Background: Probiotics are used as therapeutic or preventive treatments for various clinical conditions, even though the efficacy and safety of probiotics are not well established. There is limited data from the United States about the knowledge and practice of probiotic recommendation or prescription by general pediatric providers. Objective: To assess knowledge and practice of probiotic use in children among general pediatric providers. Design/Methods: This was a cross-sectional study with the target population of general pediatric provider. A survey was developed and piloted before distribution via the online survey tool ‘Redcap’ to the members of the American Academy of Pediatrics, New York chapter 1. The study was approved by the institutional review board of SUNY Upstate Medical University. Results: A total of 168 responses were received. Most of the respondents were female (69 %), had an MD or equivalent degree (93 %), and practiced in a private setting office (46 %). Only half of respondents had selected the correct definition of probiotics, that is ‘Probiotics are live microorganisms that when administered in adequate amounts confer a health benefit on the host’. About 97% of practitioners were asked about the probiotics by the families and 60 % of respondents had prescribed probiotics in their routine clinical practice. The most common indication for prescription was for treatment of antibiotic-associated diarrhea followed by prevention of Clostridioides difficile, and treatment of acute diarrhea (figure). When asked about their recommendation for a family who had already started probiotics, 66 % of the providers recommended continuing the supplement. The chi-square test for univariable analysis showed no association between the prescription of probiotics and age, gender, education type, and year of practice. However practitioners in private practice were more likely to prescribe probiotics compared to providers in academic institutions or combination, 56 %, 33 %, and 11 %, respectively, p=0.04.
Conclusion(s): Pediatricians were commonly asked about probiotics, and most recommended continuing if a family was using probiotics for a certain condition. Providers practicing in private offices were more likely to prescribe probiotics. This study informs general pediatricians' current knowledge, and practice; however, the sample was representative of a selected group of pediatricians and not the United States. Larger studies with a representative national sample will be required for future research.
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