264Antibiotic use associated with acute gastroenteritis in Australian primary care

Background Inappropriate antibiotic use is a global health concern as it increases antibiotic resistance. Antibiotics are not routinely recommended for treating acute gastroenteritis, non-typhoidal salmonella and campylobacter infections. We investigated adherence to these recommendations in primary care. Methods We used a large electronic database of primary care records to identify presentations for acute gastroenteritis, non-typhoidal salmonella and campylobacter infections and antibiotic prescribing from 1st Jan 2013 to 31 December 2018. We estimated the proportions of cases prescribed antibiotics according to various characteristics and examined the antibiotics prescribed. Results A total of 86998, 1106, and 1952 participants were identified with acute gastroenteritis, non-typhoidal salmonella, and campylobacter infections and correspondingly 10% (8720/86998), 40% (437/1106), and 57% (1118/1952) of these cases were prescribed antibiotics in the period up to 5 days post-diagnosis. Patients residing in outer regional/remote areas and those from Northern Territory and Queensland were more likely to be prescribed antibiotics than those residing in major cities and those from other states (p < =0.04). No dominant antibiotic class was prescribed for acute gastroenteritis. Quinolones (28.6%) and macrolides (27.0%) were the most frequently prescribed antibiotics for non-typhoidal salmonella, and macrolides (69%) were the predominant antibiotics prescribed for campylobacter. Conclusion The high proportion of antibiotics dispensed in the general population with acute gastroenteritis, non-typhoidal salmonella and campylobacter infections suggests that antimicrobial stewardship needs to include better education and awareness around treatment guidelines for such infections. Key messages Antibiotics use was common for Australian population with acute gastroenteritis, particularly those with non-typhoidal salmonella and campylobacter infections.