title: [Has the use of antipyretics been modified after the introduction of different concentrations of ibuprofen into the market?].
abstract: BACKGROUND
  Due to the emergence of new pharmaceutical presentations of ibuprofen (40 mg/ml), an analysis was made on the use of antipyretics in pediatric outpatient in Spain.
  
  
  METHODS
  A cross-sectional, observational, descriptive study was carried out on a sample of children under 14 years old with treated febrile syndrome, seen in the Emergency Room of the Hospital General Universitario de Valencia from November 2012 to January 2013.
  
  
  RESULTS
  Of the 217 children included, 144 were treated with paracetamol or ibuprofen, 69 received both drugs, and one received paracetamol and metamizol. There were 58.7% of exposures to paracetamol and 40.9% to ibuprofen. The parents decided the use of antipyretics in 63.2% of cases. In 98 exposures the dose was different from that authorized in the labeling of the drug (off-label use). Ibuprofen was used off-label in 40.2% of cases, mostly by underdosing (35.9%). Paracetamol was used off-label in 29.8% of cases, predominantly overdose (26.8%), with the difference being statistically significant. No significant differences were observed in the off-label use in either monotherapy or combined use. There were also no differences when antipyretics prescribed by doctors or given directly by parents were evaluated separately.
  
  
  CONCLUSIONS
  The majority of children with treated febrile syndrome seen in the Emergency Room were receiving antipyretic drugs after a parental decision. Paracetamol is the most commonly used drug and one in three children received it simultaneously with ibuprofen. The antipyretics were used off label in one-third of the cases. Off label use of ibuprofen is increasing, and is probably due to the existence of different pharmaceutical presentations.
authors.affiliation: Servicio de Pediatría, Consorcio Hospital General Universitario, Valencia, España.
authors.forename: C P
authors.initials: CP
authors.lastname: García Blanes
authors.affiliation: Servicio de Pediatría, Consorcio Hospital General Universitario, Valencia, España.
authors.forename: P
authors.initials: P
authors.lastname: Rodríguez-Cantón Pascual
authors.affiliation: Servicio de Pediatría, Consorcio Hospital General Universitario, Valencia, España; Centro de Salud de Picassent, Picassent, Valencia, España. Electronic address: crismocar@hotmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Morales-Carpi
authors.affiliation: Departamento de Farmacología, Universitat de València, Valencia, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Morales-Olivas
mesh_terms: D000293:Adolescent; D058633:Antipyretics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D007223:Infant
chemical_list: D058633:Antipyretics; D007052:Ibuprofen
keywords: Children; Drug use; Fever; Fiebre; Ibuprofen; Ibuprofeno; Niños; Off-label use; Paracetamol; Uso «off-label»; Utilización de medicamentos