PROBIOTICS IN TREATMENT OF ATOPIC DERMATITIS - KNOWLEDGE AND ATTITUDE AMONG SERBIAN PHYSICIANS
DOI:
https://doi.org/10.46793/PP260130008FKeywords:
atopic dermatitis, children, probioticsAbstract
Introduction: Since the 1970s, AD incidence has increased 2- to 3-fold in industrialized nations, impacting approximately 15% to 20% of children, 5% to 20% of adolescents.
Materials and methods: This was 6 months (January to June 2024) retrospective study collecting data through a web-based questionnaire designed to measure knowledge and attitude of Serbian physicians towards AD diagnosis, treatment and prevention strategies. The participants were healthcare professionals, specialists who are treating patients with AD. Surveys can reveal gaps in knowledge, concerns about safety or effectiveness, and the need for further training or support. This insight can help improve clinical guidelines, promote evidence-based practices, and ensure patients receive comprehensive and up-to-date care.
Results: Patients with Atopic Dermatitis in Serbia were mostly treated by physicians specialized in pediatrics and dermatology (210 dermatologist and 218 pediatricians were included). Virtually all participants agreed that discovering and avoiding triggering factors are crucial to keep AD under control. Among our participants diagnosing and staging of AD are mostly based on clinical criteria including assessment of itching intensity and sleep disturbance using visual analogue scales and overall quality of life.
Discussion: Results of our survey has the potential to identify current knowledge gaps and attitudes of physicians who are treating patients with atopic dermatitis. Physicians who experience less difficulties while treating AD have more positive practice attitudes and treatment satisfaction rates.
Conclusion: Continuous medical education, open-mindedness to evolving evidence, and a genuine commitment to understanding the patient’s lived experience are essential for elevating care quality in this challenging and burdensome condition.
References
Richard MA, Paul C, Nijsten T, Gisondi P, Salavastru C, Taieb C, et al. Prevalence of most common skin diseases in Europe: a population-based study. J Eur Acad Dermatol Venereol. 2022;36:1088-96. doi: 10.1111/jdv.18050
Drucker AM, Wang AR, Li W-Q, Sevetson E, Block JK, Qureshi AA. The burden of atopic dermatitis: summary of a report for the National Eczema Association. J Invest Dermatol. 2017;137:26-30. doi: 10.1016/j.jid.2016.07.012
Korting HC, Hubner K, Greiner K, Hamm G, Braunfalco O. Differences in the skin surface pH and bacterial microflora due to the long-term application of synthetic detergent preparations of pH 5.5 and pH 7.0 - results of a crossover trial in healthy-volunteers. Acta Derm Venereol. 1990;70:429-31. PMID: 1980979
Hoyer A, Rehbinder EM, Fardig M, Asad S, Lødrup Carlsen KC, Endre KMA, et al. Filaggrin mutations in relation to skin barrier and atopic dermatitis in early infancy. Br J Dermatol. 2022;186:544-52. doi: 10.1111/bjd.21645
Lambers H, Piessens S, Bloem A, Pronk H, Finkel P. Natural skin surface pH is on average below 5, which is beneficial for its resident flora. Int J Cosmet Sci. 2006;28:359-70. doi: 10.1111/j.1467-2494.2006.00344.x
Eyerich S, Eyerich K, Traidl-Hoffmann C, Biedermann T. Cutaneous barriers and skin immunity: differentiating a connected network. Trends Immunol. 2018;39: 315-27. doi: 10.1016/j.it.2018.02.004
Park J, Schwardt NH, Jo JH, Zhang Z, Pillai V, Phang S, et al. Shifts in the skin bacterial and fungal communities of healthy children transitioning through puberty. J Invest Dermatol. 2022;142:212-9. doi: 10.1016/j.jid.2021.04.034
Schneider AM, Nolan ZT, Banerjee K, Paine AR, Cong Z, Gettle SL, et al. Evolution of the facial skin microbiome during puberty in normal and acne skin. J Eur Acad Dermatol Venereol. 2023;37:166-75. doi: 10.1111/jdv.18616
Smythe P, Wilkinson HN. The skin microbiome: current landscape and future opportunities. Int J Mol Sci. 2023;24:3950. doi: 10.3390/ijms24043950
Casterline BW, Paller AS. Early development of the skin microbiome: therapeutic opportunities. Pediatr Res. 2021;90:731-7. doi: 10.1038/s41390-020-01146-2
Luna PC. Skin microbiome as years go by. Am J Clin Dermatol. 2020;21:12-7. doi: 10.1007/s40257-020-00549-5
Rosenwasser L, Sampson H, Spigler M, Terracciano L, Vereda-Ortiz A, Waserman S, Yepes-Nuñez JJ, Brożek JL, Schünemann HJ. World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Probiotics. World Allergy Organ J. 2015;8(1):4. doi: 10.1186/s40413-015-0055-2
Filipovic I, Ostojic O, Vekovic V, Mihajlovic S, Caminati M, Zivkovic Z. Efficacy of Specially Formulated Combination Three Probiotic Strains with Vitamin D3 and Zn in Children with Atopic Dermatitis. Am J Pediatr. 2023;9(4):186-192. doi: 10.11648/j.ajp.20230904.11
Zuberbier T, Abdul Latiff A et al. A concept for integrated care pathways for atopic dermatitis-A GA2 LEN ADCARE initiative. Clin Transl Allergy. 2023;13(9):e12299. doi: 10.1002/clt2.12299
Williams NT. Probiotics. Am J Health Syst Pharm 2010;67:449-58. doi: 10.2146/ajhp090168
Filipović I, Lacković M, Plješa I, Mihajlović S, Živković Z, et at. Uloga probiotika u primarnoj prevenciji atopijskih bolesti - Kad je pravo vreme? Prev Ped, 2021; 7(1-2):27-30.
McLoughlin IJ, Wright EM, Tagg JR, Jain R, Hale JDF. Skin microbiome-the next frontier for probiotic intervention. Probiotics Antimicrob Proteins. 2022;14: 630-47. doi: 10.1007/s12602-021-09824-1
Carucci L, Nocerino R, Paparo L, De Filippis F, Coppola S, Giglio V, et al. Therapeutic effects elicited by the probiotic Lacticaseibacillus rhamnosus GG in children with atopic dermatitis. The results of the ProPAD trial. Pediatr Allergy Immunol. 2022;33:e13836. doi: 10.1111/pai.13836
Filipovic I, Ostojic O, Vekovic V, Mihajlovic S, Caminati M, Zivkovic Z. Efficacy of Specially Formulated Combination Three Probiotic Strains with Vitamin D3 and Zn in Children with Atopic Dermatitis. Am J Pediatr. 2023;9(4):186-192. doi: 10.11648/j.ajp.20230904.11
Zuberbier T, Abdul Latiff A, et al. A concept for integrated care pathways for atopic dermatitis-A GA2 LEN ADCARE initiative. Clin Transl Allergy. 2023;13(9):e12299. doi: 10.1002/clt2.12299
Li AW, Yin ES, Antaya RJ. Topical corticosteroid phobia in atopic dermatitis: a systematic review. JAMA Dermatol. 2017;153(10):1036‐1042. doi: 10.1001/jamadermatol.2017.2437
Castagnoli R, Lougaris V, Giardino G, et al. Inborn errors of immunity with atopic phenotypes: a practical guide for allergists. World Allergy Organ J. 2021;14(2):100513. doi: 10.1016/j.waojou.2021.100513
Caminati M, Filipović I, Živković Z. Probiotics in Treatment of Atopic Dermatitis True or Myth. Prev Ped 2025;11(1−2):25−27. doi: 10.46793/PP250228007C
