Objective  To explore the relationship between the symptoms of gastrointestinal infection and antimicrobial use among rural residents in Anhui province and to provide a theoretical guidance for implementing correct measures against gastrointestinal infections.

  Methods  Using cluster random sampling, we conducted a household interview among rural residents aged ≥ 18 years in 24 administration villages of 12 counties across central, northern and southern regions of Ahhui province in May 2016. A structured questionnaire on demographic information, gastrointestinal infection-related symptoms and health service utilization was adopted in the survey.

  Results  Valid information were collected from a total of 3 622 participants and the response rate of the survey was 98.6%. For all the participants during the previous one year, the incidence rate of gastrointestinal infection symptoms was 23.7% and the average incident of the symptoms of was 0.62 person-time. Of the participants with gastrointestinal infection experience, 73.3% reported the utilization of health care services. Of the users of health care service, 74.6% reported using antibiotics; 62.2% reported visiting a doctor; 25.5% reported conducing self medication; and 12.3% reported the utilization of two or more items of health care service. The number of gastrointestinal infection-related symptoms was positively correlated significantly with utilization of outpatient service and antimicrobial usage.

  Conclusion  Gastrointestinal infection-related symptoms is an important factor affecting the usage of antibiotics among rural adult residents in Anhui province and concerns should be paid on relevant studies.