title: A survey of probiotic use practices among patients at a tertiary medical centre.
abstract: Probiotic use has skyrocketed in recent years. Little is known, however, about patient knowledge and practices regarding probiotic use, especially in the context of antibiotic use. An invitation to complete a short, anonymous, electronic survey was sent by email to 965 patients at a tertiary medical centre in California who had agreed to be contacted for participation in research studies. Questions were asked about both probiotic and antibiotic use in the prior three months. Of 333 survey respondents, 55% had recently used probiotics, including food products and/or supplements (90 and 60% of probiotic users, respectively). Women were more likely than men to have used probiotics (odds ratio (OR): 1.99; 95% confidence interval (CI): 1.2-3.4). Health care providers (HCP) had prescribed antibiotics to 79 (24%) respondents in the preceding three months. Among antibiotic users, 33% had initiated or changed probiotics at the time of antibiotic use, usually without a recommendation from their prescribing HCP (72%). Only 12% of those who took probiotics with antibiotics had received a specific recommendation from their HCP. Most patients chose to take probiotic mixtures (56%), with few selecting evidence-based strains, such as Lactobacillus rhamnosus GG (11%). Regular probiotic use among patients is common. Typically, these probiotics are not recommended by a HCP, even in conjunction with antibiotic prescriptions. While a growing body of evidence supports specific probiotic strains for the prevention of antibiotic-associated diarrhoea, patients are often not receiving a specific recommendation from their HCP and appear to be taking strains without guidance from supporting evidence.
authors.affiliation: 1 Division of Gastroenterology and Hepatology, Stanford School of Medicine, 300 Pasteur Drive, MC 5187, Stanford, CA 94305-5119, USA.
authors.forename: K
authors.initials: K
authors.lastname: Draper
authors.affiliation: 2 Division of Infectious Diseases and Geographic Medicine, Stanford School of Medicine, 300 Pasteur Drive, MC 5187, Stanford, CA 94305-5119, USA.
authors.forename: C
authors.initials: C
authors.lastname: Ley
authors.affiliation: 2 Division of Infectious Diseases and Geographic Medicine, Stanford School of Medicine, 300 Pasteur Drive, MC 5187, Stanford, CA 94305-5119, USA.|3 Health Research and Policy, Department of Medicine, Stanford School of Medicine, 150 Governor's Lane, HRP Redwood Building, Stanford, CA 94305-5405, USA.
authors.forename: J
authors.initials: J
authors.lastname: Parsonnet
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D003967:Diarrhea / Q000139:chemically induced / Q000517:prevention & control; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D052201:Lacticaseibacillus rhamnosus; D008297:Male; D008875:Middle Aged; D019936:Probiotics / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents
keywords: alternative; antibiotic; complementary; microbiome