439. Impact of Pre-Travel Consultation on Clinical Management and Outcomes of Traveler’s Diarrhea

BACKGROUND: International travelers are at high risk of acquiring traveler’s diarrhea. Pre-travel consultation has been associated with lower rates of infections. The objective was to study the impact of pre-travel consultation on clinical management and outcomes of traveler’s diarrhea. METHODS: This retrospective cohort study analyzed 1,160 patients diagnosed with traveler’s diarrhea at Mayo Clinic Rochester, Minnesota from 1994 to 2017. Variables included high-risk activities, post-travel care utilization, antimicrobial prescriptions, hospitalizations, and complications. Travelers were divided into those who sought (n = 256) and did not seek (n = 904) pre-travel consultation. RESULTS: Pre-travel consultation was associated with more post-travel infectious disease (ID) consultation [OR 3.2 (95% CI 1.9–5.4)], more stool sampling [OR 1.6 (95% CI 1.1–2.4)], and more antimicrobial prescriptions [OR 1.6 (95% CI 1.04–2.4)] compared with the non-pre-travel consultation group. The pre-travel consultation group had shorter hospital stays (adjusted mean 1.8 days for pre-travel vs. 3.3 days for non-pre-travel consultation group, P = 0.01) and reduced gastroenterology consultation rates [OR 0.2 (95% CI 0.06–0.97)]. CONCLUSION: Pre-travel and ID consultation may have facilitated appropriate management of traveler’s diarrhea, which reduced duration of hospitalization and gastroenterology consultation for prolonged or severe symptoms. These results support the important role of the ID physician in managing traveler’s diarrhea. DISCLOSURES: All authors: No reported disclosures.