High levels of antibiotic use in the treatment of campylobacteriosis
PHE ePoster Library. Douglas A. Apr 9, 2019; 257481; 15328
Amy Douglas
Amy Douglas
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Abstract
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Abstract Campylobacter is the leading cause of bacterial gastroenteritis in the UK with an estimated 400,000 community cases annually. National guidance advises the use of antibiotics only for severe or persistent (>7 days) illness and for vulnerable individuals. The Campylobacter Sentinel Surveillance Study was conducted across two sites covering a population representative of England and Wales (Office for National Statistics Rural Urban Classification). In this analysis we examined self-reported antibiotic use among 2,394 cases between October 2015 and September 2017 who completed questionnaires.Questionnaire data were linked to Rural Urban Classification code and Indices of Multiple Deprivation (IMD) score based on postcode location. Antibiotic use was defined as starting or switching to an antibiotic recommended for the treatment of campylobacteriosis after stool sample collection. Univariate analyses were conducted and multivariate logistic regression analysis including variables identified in national guidance for treatment of campylobacteriosis, or with p≤ 0.1 on univariate analysis. We tested for interactions and used likelihood ratio tests to determine the most parsimonious model.Reported use of antibiotics was high (35.6%) and differed between the sentinel sites (OR 2.52, 95% CI 2.07-3.06, p<0.001) and there was significant variation among GP practices. Site effects remained in the multivariate analysis. In one site macrolide antibiotic treatment was mainly erythromycin (75.9%) and in the other clarithromycin (77.9%). Longer periods of illness were associated with reported antibiotic use (OR 2.37, 95% CI 1.89-2.99, p<0.001). The high level of antibiotic use for this self-limiting illness, and variation across the two sentinel sites, is striking. This identifies GI infections as an area for increased attention to antimicrobial stewardship. Funding This research was funded by the Food Standards Agency and supported by Kirsten Stone and Kara Thomas at the agency.
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