AIM:To assess attitudes and trends regarding the use of high-dose infliximab among pediatric gastroenterologists for treatment of pediatric ulcerative colitis(UC).METHODS:A 19-item survey was distributed to subscribers of the pediatric gastroenterology(PEDSGI) listserv.Responses were submitted anonymously and results compiled in a secure website.RESULTS:A total of 113 subscribers(88% based in the United States) responded(101 pediatric gastroenterology attendings and 12 pediatric gastroenterology fellows).There were 46% in academic medical institutions and 39% in hospital-based practices.The majority(91%) were treating >10 patients with UC;13% were treating >100 patients with UC;91% had prescribed infliximab(IFX) 5 mg/kg for UC;72% had prescribed IFX 10 mg/kg for UC.Using a 5-point Likert scale,factors that influenced the decision not to increase IFX dosing in patients with UC included:“improvement on initial dose of IFX”(mean:3.88) and “decision to move to colectomy”(3.69).Lowest mean Likert scores were:“lack of guidelines or literature regarding increased IFX dosing”(1.96) and “insurance authorization or other insurance issues”(2.34).“Insurance authorization or other insurance issues” was identified by 39% as at least somewhat of a factor(Likert score ≥ 3) in their decision not to increase the IFX dose.IFX 10 mg/kg was more commonly used for the treatment of pediatric UC among responders based in the United States(75/100) compared to non-United States responders(6/13,P = 0.047).Induction of remission was reported by 78% of all responders and 81% reported maintenance of remission with IFX 10 mg/kg.One responder reported one death with IFX 10 mg/kg.CONCLUSION:IFX 10 mg/kg is more commonly used in the United States to treat pediatric UC.Efficacy and safety data are required to avoid insurance barriers for its use. AIM: To assess attitudes and trends regarding the use of high-dose infliximab among pediatric gastroenterologists for treatment of pediatric ulcerative colitis (UC). METHODS: A 19-item survey was distributed to subscribers of the pediatric gastroenterology (PEDSGI) listserv. Responses were submitted anonymously and results compiled in a secure website .RESULTS: A total of 113 subscribers (88% based in the United States) responded (101 pediatric gastroenterology attendations and 12 pediatric gastroenterology fellows) .There were 46% in academic medical institutions and 39% inpatient> 10 patients with UC; 13% had treating> 100 patients with UC; 91% had prescribed infliximab (IFX) 5 mg / kg for UC; 72% had prescribed IFX 10 mg / kg for UC. Using a 5-point Likert scale, factors that affect the decision not to increase IFX dosing in patients with UC included: “” improvement on initial dose of IFX “(mean: 3.88) and ” decision to move to colectomy “(3.69) .Lowest m ean Likert scores were: ”lack of guidelines or literature versus increased IFX dosing “ (1.96) and ”insurance authorization or other insurance issues “ (2.34). ”Insurance authorization or other insurance issues " was identified by 39 % as at least somewhat of a factor (Likert score ≥ 3) in their decision not to increase the IFX dose. IFX 10 mg / kg was more commonly used for the treatment of pediatric UC among responders based in the United States (75/100 ) compared to non-United States responders (6/13, P = 0.047). Induction of remission was reported by 78% of all responders and 81% reported maintenance of remission with IFX 10 mg / kg. One responder reported one death with IFX 10 mg / kg.CONCLUSION: IFX 10 mg / kg is more commonly used in the United States to treat pediatric UC .Efficacy and safety data are required to avoid insurance barriers for its use.