Symptomatic fever management among 3 different groups of pediatricians in Northern Lombardy (Italy): results of an explorative cross-sectional survey

Italian Journal of Pediatrics

Sebastiano Antonio Giovanni Lava⁵  Cino Galluzzo⁶  Luigi Nespoli⁴  Mario Giovanni Bianchetti⁵  Francesco Saettini³  Maddalena Marinoni⁴  Anna Villella²  Felice Cogliati¹  Maria Cristina Provero⁴  Alberto Bettinelli¹ 

[1] Department of Pediatrics, San Leopoldo Mandic Hospital, Merate, Italy;Community Pediatrician, Merate, Italy;Department of Pediatrics, San Gerardo Hospital, Monza, Italy;Department of Clinical and Experimental Medicine, Ospedale Pediatrico Filippo del Ponte, Varese, Italy;Department of Pediatrics, San Giovanni Hospital, Bellinzona and University of Bern, Bern, Switzerland;Department of Pediatrics, Fatebenefratelli Hospital, Erba, Como, Italy

关键词: Ibuprofen;    Acetaminophen (paracetamol);    Pediatrician attitudes;    Fever;   

Others  :  824990
DOI  :  10.1186/1824-7288-39-51

 received in 2013-06-06, accepted in 2013-08-27,  发布年份 2013

【 摘 要 】

Background

In the care of feverish children, symptomatic management is pivotal. Thus, the Italian Pediatric Society has recently published guidelines on fever management in children. Our aim was to investigate whether pediatric hospitalists, community pediatricians and pediatric residents differ in their every-day clinical practice with respect to symptomatic management of feverish children.

Methods

79 out of 118 physicians involved in pediatric care in an area of Northern Lombardy (Italy) filled in a modified version of the questionnaire derived from the Swiss national survey on symptomatic fever management.

Results

Pediatric hospitalists (N = 29), community pediatricians (N = 30) and pediatric residents (N = 20) did not differ with respect to temperature threshold for symptomatic fever treatment, role of general appearance in modulating the threshold for fever management, first choice antipyretic drug, frequency of ibuprofen prescription, prescription of physical antipyresis, influence of exaggerated fear of fever on its management and potential to reassure families about this fear.

On the other side, some significant differences were found. Pediatric residents more frequently lower the treatment threshold in children with a past history of febrile seizures (P < 0.001) and prescribe an aggressive treatment for fever not responding to the first antipyretic drug (P < 0.01) than their more experienced colleagues. Community pediatricians represent the unique investigated group using homeopathic remedies, both in the acute setting (P < 0.001) as well as a prophylaxis (P < 0.0001). Finally, paediatric residents less often (P < 0.05) stated to encounter exaggerated fear of fever among parents than their more experienced colleagues.

Conclusions

The present explorative inquiry globally shows limited discordance among pediatric residents, community pediatricians and pediatric hospitalists with respect to symptomatic fever management.

【 授权许可】

   
2013 Bettinelli et al.; licensee BioMed Central Ltd.

【 图 表 】

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