title: Therapeutic procedures and use of alternating antipyretic drugs for fever management in children.
abstract: OBJECTIVE
  The evidence on the effectiveness of alternating antipyretics in fever management is scarce and indicates clinically negligible differences. The present study aimed to describe therapeutic procedures and the use of alternating antipyretics in children, and to evaluate associated factors.
  
  
  METHODS
  This was a cross-sectional study with 692 children aged 0 to 6 years, living in Southern Brazil. Household interviews of the children's caregivers were conducted through cluster sampling using a structured questionnaire. A descriptive analysis was carried out, and the association between the use of alternating antipyretics and sociodemographic factors was evaluated. A total of 630 cases were analyzed (91.0%), corresponding to children with a history of fever.
  
  
  RESULTS
  Approximately 73% of caregivers reported that the first measure adopted during the last fever episode was the administration of medication. The mean temperature considered as fever by caregivers was 37.4°C, and as high fever, 38.7°C. The use of alternating antipyretic therapy was reported by 26.7% of respondents, justified by the lack of response to monotherapy and medical indication, in most cases. The drugs most often used were dipyrone and paracetamol. Children whose primary caregiver was a parent with higher socioeconomic status and higher educational level received more alternating medications. Approximately 70% of the doses used were below the minimum recommended dose for the treatment of fever.
  
  
  CONCLUSIONS
  The use of medication to control fever is a common practice, including alternating antipyretic regimens. Most caregivers consider as fever temperatures lower than those established and they reported lack of response to monotherapy and medical indication as the main reasons for alternating medication.
authors.affiliation: Postgraduate Program in Epidemiology, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Gracian Li
authors.initials: GL
authors.lastname: Pereira
authors.forename: Noemia U L
authors.initials: NU
authors.lastname: Tavares
authors.forename: Sotero S
authors.initials: SS
authors.lastname: Mengue
authors.forename: Tatiane da S Dal
authors.initials: Tda S
authors.lastname: Pizzol
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage; D058633:Antipyretics / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004177:Dipyrone / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population
chemical_list: D058633:Antipyretics; D000082:Acetaminophen; D004177:Dipyrone