title: Symptomatic fever management among 3 different groups of pediatricians in Northern Lombardy (Italy): results of an explorative cross-sectional survey.
abstract: 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.
authors.affiliation: Department of Pediatrics, San Leopoldo Mandic Hospital, Merate, Italy. a.bet@libero.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bettinelli
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Provero
authors.forename: Felice
authors.initials: F
authors.lastname: Cogliati
authors.forename: Anna
authors.initials: A
authors.lastname: Villella
authors.forename: Maddalena
authors.initials: M
authors.lastname: Marinoni
authors.forename: Francesco
authors.initials: F
authors.lastname: Saettini
authors.forename: Mario Giovanni
authors.initials: MG
authors.lastname: Bianchetti
authors.forename: Luigi
authors.initials: L
authors.lastname: Nespoli
authors.forename: Cino
authors.initials: C
authors.lastname: Galluzzo
authors.forename: Sebastiano Antonio Giovanni
authors.initials: SA
authors.lastname: Lava
mesh_terms: D058633:Antipyretics / Q000008:administration & dosage* / Q000494:pharmacology; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D003430:Cross-Sectional Studies; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000188:drug therapy*; D020445:Hospitalists / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007396:Internship and Residency / Q000706:statistics & numerical data; D007558:Italy; D008297:Male; D010372:Pediatrics / Q000379:methods; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D058633:Antipyretics