title: [Use of alternating antipyretics in the treatment of fever in Spain].
abstract: OBJECTIVE
  To assess the frequency of the use of alternating antipyretics among Spanish pediatricians and to analyze the factors that determine this practice.
  
  
  METHODS
  An anonymous survey of practicing pediatricians was conducted. Data on the use of antipyretics were collected. Factors related to alternating antipyretics were assessed by using multivariate correlation analyses.
  
  
  RESULTS
  Three hundred twenty-four questionnaires were reviewed. The mean age of participants was 46.4 18.6 years (29-68 years). Of the responding pediatricians, 22.5 % worked in hospitals, 87.5 % in health centres and 24.7 % in in private practice. A total of 68.8 % of pediatricians (95 % CI: 63.4-73.8 %) alternated antipyretics. The combination of ibuprofen and acetaminophen was recommended by 96.9 %. The use of alternating antipyretics was positively associated with male sex (OR: 0.535; 95 % CI: 0.296-0.967; p 0.038), with few years' experience (OR: 0.952; 95 % CI: 0.922-0.984, p 0.005), with considering ibuprofen the drug of choice (OR: 2.324; 95 % CI: 1.235-4.372; p 0.009) and with the doctor's recommendation that the antipyretic be readministered in the event of slight increases in temperature (OR: 0.529; 95 % CI: 0.310-0.901; p 0.019).
  
  
  CONCLUSIONS
  Despite the lack of scientific evidence to justify the practice, the use of alternating antipyretics is common in the treatment of febrile children. Predictive factors of this practice among pediatricians are male sex, having relatively little experience, considering ibuprofen as the drug of choice and recommending the administration of new doses of antipyretic to control mild fever.
authors.affiliation: Centro de Salud de Nazaret, Valencia, Spain. diez_jav@gva.es
authors.forename: J
authors.initials: J
authors.lastname: Díez Domingo
authors.forename: A
authors.initials: A
authors.lastname: Burgos Ramírez
authors.forename: J
authors.initials: J
authors.lastname: Garrido García
authors.forename: A
authors.initials: A
authors.lastname: Ballester Sanz
authors.forename: E
authors.initials: E
authors.lastname: Moreno Carretero
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005334:Fever / Q000188:drug therapy*; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage; D007223:Infant; D010372:Pediatrics; D010818:Practice Patterns, Physicians'; D013030:Spain
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen; D007052:Ibuprofen