Zvi Weizman1. 1. Pediatric Gastroenterology and Nutrition Unit, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel. wzvi@bgu.ac.il
Abstract
GOALS: To evaluate practices and barriers for the use of probiotics in acute diarrhea among pediatric gastroenterologists. BACKGROUND: Probiotics have shown significant therapeutic potential in acute infectious diarrhea. However, literature data regarding practice patterns in childhood are limited. STUDY: A web-based 9-item survey among 1854 pediatric gastroenterologists worldwide. RESULTS: Only 634 (34%) responded. Forty-one were excluded owing to incomplete data. Finally 593, USA (n=407) and non-USA (n=186) participants, showed: limited use in acute diarrhea (28% and 32% prospectively), prescription of a 1 strain product only by 31% and 24%, respectively, and limited utilization in ambulatory settings (43% and 51%, respectively) and in prevention of diarrhea (2.6% and 3.4%, respectively). Most participants felt there is lack of useful clinical guidelines (91% and 84%, respectively), and found this therapy effective or very effective (54% and 62%, respectively). Dosing and duration were extremely variable, the youngest age treated ranged from 2 months to 2 years of age, and adverse effects were extremely rare. These characteristics were shared by USA and by non-USA participants, with no significant differences between groups (P>0.05). CONCLUSIONS: Many pediatric gastroenterologists worldwide do not use probiotics for acute diarrhea owing to lack of appropriate guidelines and/or poorly designed products. Therefore, worldwide health authorities should provide pharmaceutical and clinical guidelines for the appropriate use of probiotics in acute diarrhea of childhood.
GOALS: To evaluate practices and barriers for the use of probiotics in acute diarrhea among pediatric gastroenterologists. BACKGROUND: Probiotics have shown significant therapeutic potential in acute infectious diarrhea. However, literature data regarding practice patterns in childhood are limited. STUDY: A web-based 9-item survey among 1854 pediatric gastroenterologists worldwide. RESULTS: Only 634 (34%) responded. Forty-one were excluded owing to incomplete data. Finally 593, USA (n=407) and non-USA (n=186) participants, showed: limited use in acute diarrhea (28% and 32% prospectively), prescription of a 1 strain product only by 31% and 24%, respectively, and limited utilization in ambulatory settings (43% and 51%, respectively) and in prevention of diarrhea (2.6% and 3.4%, respectively). Most participants felt there is lack of useful clinical guidelines (91% and 84%, respectively), and found this therapy effective or very effective (54% and 62%, respectively). Dosing and duration were extremely variable, the youngest age treated ranged from 2 months to 2 years of age, and adverse effects were extremely rare. These characteristics were shared by USA and by non-USA participants, with no significant differences between groups (P>0.05). CONCLUSIONS: Many pediatric gastroenterologists worldwide do not use probiotics for acute diarrhea owing to lack of appropriate guidelines and/or poorly designed products. Therefore, worldwide health authorities should provide pharmaceutical and clinical guidelines for the appropriate use of probiotics in acute diarrhea of childhood.
Authors: Michelle W Parker; Joshua K Schaffzin; Andrea Lo Vecchio; Connie Yau; Karen Vonderhaar; Amy Guiot; William B Brinkman; Christine M White; Jeffrey M Simmons; Wendy E Gerhardt; Uma R Kotagal; Patrick H Conway Journal: Pediatrics Date: 2013-03 Impact factor: 7.124
Authors: Stephen B Freedman; Sarah Williamson-Urquhart; Suzanne Schuh; Philip M Sherman; Ken J Farion; Serge Gouin; Andrew R Willan; Ron Goeree; David W Johnson; Karen Black; David Schnadower; Marc H Gorelick Journal: Trials Date: 2014-05-14 Impact factor: 2.279