University of Naples Federico II, Italy
Objective: The aim of this study was to evaluate the knowledge, attitudes and current practices of physicians with regards to probiotics in 10 countries. Methods: A closed-ended structured questionnaire was implemented in 10 different countries (Argentina, Peru, Spain, Italy, Hungary, Morocco, Turkey, Pakistan, India and China). Target and Sample Size: 90 to 190 physicians interviewed per country (General Practitioners-GP-, Pediatricians-P-, Gastroenterologists-G-). Total sample: 1670. Representativeness: adapted criteria according to each country's reality (quota method). Results: 85% doctors in 10 countries felt that they were somewhat or absolutely informed about probiotics, with the highest prevalence among G in China (100%) and GP in China (93%), India (91%). However 39% Moroccan physicians expressed a lack of information. Concerning probiotic definition 94% of Turkish doctors responded according to FAO/WHO criteria while in Pakistan only 39% of doctors did. Saccharomyces boulardii and Lactobacillus rhamnosus GG have been scientifically proven to work in acute infectious diarrhea and antibiotic associated diarrhea (46% and 30%) showing very different scores with no parallel with global guidelines. GPs are less aware of proofs on these strains in these indications whereas P remain the most aware target in the sample (36% boulardii/20% GG in GPs vs 51%/35% in P population). There is an international consensus on safety (84%) with no differences per target. Doctors do recommend probiotics to their family (82%) or themselves (68%). P recommend more frequently probiotics in acute diarrhea (in average 62,4 patients/100). Conclusions: Most doctors feel well informed about probiotics.