Microbiota, probiotics, and prebiotics: a cross-sectional survey of healthcare professionals’ knowledge, attitudes, and practices

This cross-sectional study aimed to assess healthcare professionals’ understanding of microbiota, probiotics, and prebiotics, along with their attitudes and practical approaches toward probiotic and prebiotic products. Using convenience sampling, 320 healthcare professionals were recruited through a national online convenience survey distributed via professional networks and social media platforms, comprising physicians ( n = 78, 24.4%), nurses ( n = 78, 24.4%), dietitians ( n = 86, 26.9%), and pharmacists ( n = 78, 24.4%). Microbiota awareness was assessed using the validated Microbiota Awareness Scale (MAS; score range: 18–100; higher scores indicate greater awareness), and a structured questionnaire assessed probiotic and prebiotic knowledge, attitudes, and practices. The overall MAS score was 77.00 ± 8.5 out of 100 (theoretical range: 18–100). As no validated cut-off exists for the MAS, absolute classification of awareness levels is not possible; findings are best interpreted in terms of relative differences across professional groups. Significant differences were observed across professional groups (Kruskal-Wallis, p < 0.001), with dietitians achieving the highest scores (83.39 ± 6.1), followed by pharmacists (77.89 ± 7.6), nurses (73.66 ± 8.5), and physicians (72.42 ± 6.9); post-hoc analyses confirmed that dietitians scored significantly higher than all other groups ( p < 0.05). Most participants correctly defined probiotics (76.9%) and prebiotics (71.3%), and the vast majority viewed both as beneficial for health (> 95%). However, while 72.8% reported recommending probiotic products to others, only 23.4% reported regular personal consumption. Healthcare professionals participating in this national online convenience survey demonstrated variable microbiota awareness, with significant differences across professional groups and positive attitudes toward probiotics and prebiotics. However, a clear knowledge-attitude-practice gap was identified: while 72.8% reported recommending probiotic products to others (reflecting favorable professional behavior), only 23.4% reported regular personal consumption (a distinct construct from professional recommendation behavior). This gap highlights the potential importance of structured, evidence-based educational interventions; however, as the study is cross-sectional, causal relationships between awareness and recommendation behavior cannot be established, and longitudinal research is needed.