Assessment of Knowledge, Attitudes, and Practices Regarding Microbiota Composition and Influencing Factors Among the Lebanese Population: A Cross-Sectional Study.

Background The human microbiota, formed by bacteria, viruses, and yeasts, plays a fundamental role in maintaining health and preventing disease. It is influenced by multiple factors such as age, sex, hygiene practices, and dietary habits. Its disruption, particularly through inappropriate use of antibiotics or incorrect consumption of probiotics, may have important health consequences. Over the past two decades, growing scientific evidence has highlighted the essential role of microbiota in maintaining human health. Despite the growing interest in microbiota, public knowledge, attitudes, and practices regarding these concepts remain poorly understood, especially in Lebanon, where antibiotic self-medication and widespread availability of probiotic products are common. This study aimed to assess the knowledge of microbiota and probiotics, as well as attitudes and practices affecting the microbiota among Lebanese adults aged 18 to 65 years. Methodology A descriptive, cross-sectional study was conducted between July and December 2024 using a validated self-administered questionnaire, previously used in a similar study from Jazane, distributed online through a non-probability snowball sampling method. Lebanese adults aged 18 to 65 years were included. The questionnaire assessed sociodemographic characteristics, knowledge of microbiota and probiotics, and related attitudes and practices. Descriptive statistics were performed, categorical variables were reported as frequencies and percentages, while continuous variables were presented as means, medians, standard deviations, and ranges. Associations were analyzed using chi-square tests, Student's t-test, or Mann-Whitney U test as appropriate. Pearson's correlation analysis was used to assess the relationships between knowledge, attitudes, and practices. A p-value <0.05 was considered statistically significant. Results A total of 399 participants were included, with a mean age of 32.82, and 60.4% were females. Most participants resided in South Lebanon/Nabatiyeh (42.1%), and 88% held a university degree or higher. Good knowledge of microbiota was observed in 34.3% of participants, while only 17.3% demonstrated good knowledge of probiotics. Although 72.7% had heard of probiotics, misconceptions were frequent, particularly regarding their indications and safety. Good attitudes and practices were observed in 34.3% of participants. Notably, 34.8% reported using antibiotics without a prescription, and only 14.3% reported taking probiotics after completing an antibiotic course. Good microbiota knowledge was associated with good probiotics knowledge and positive attitudes and practices (p < 0.01). Conclusions While awareness of microbiota and probiotics is relatively high among the Lebanese population, true understanding remains limited. In addition, attitudes and practices were mixed, and important misconceptions and misuse persist. Knowledge gaps are reflected in suboptimal practices. Targeted educational interventions and public health strategies are needed to promote microbiota-friendly behaviors and improve long-term health outcomes.