title: National modulators of symptomatic fever management in children: comparative analysis of survey data.
abstract: BACKGROUND
  In symptomatic fever management of children, cultural differences have been detected. We aimed at investigating the presence of national modulators of symptomatic fever management.
  
  
  METHODS
  We analyzed the data collected in the context of the Swiss national survey on symptomatic fever management in children and of an adapted version of that survey performed in Lombardy (Northern Italy).
  
  
  RESULTS
  Ibuprofen (P<0.001) and an alternation regimen with 2 drugs (P<0.001) are more often prescribed in Switzerland than in Lombardy. In front of a comfortable child whose fever has not responded to the first antipyretic, Swiss pediatricians are more aggressive than Italian colleagues (P<0.001). In an 18-month-old child, the rectal administration route of paracetamol is less often chosen in Lombardy than in Switzerland (P<0.025). Additionally, some previously identified cultural differences among linguistically different regions of Switzerland (role of reduced general appearance and perceived frequency of fever phobia) held true also beyond national borders.
  
  
  CONCLUSIONS
  Several significant differences between Northern Italy and the different speaking regions of Switzerland were detected. This suggests the existence of national modulators of symptomatic fever management in children.
authors.affiliation: University Children's Hospital, Inselspital, Bern, Switzerland - sebastiano.lava@bluewin.ch.|University of Bern, Bern, Switzerland - sebastiano.lava@bluewin.ch.|Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland - sebastiano.lava@bluewin.ch.
authors.forename: Sebastiano A
authors.initials: SA
authors.lastname: Lava
authors.affiliation: University Children's Hospital, Inselspital, Bern, Switzerland.|University of Bern, Bern, Switzerland.
authors.forename: Maristella
authors.initials: M
authors.lastname: Santi
authors.affiliation: Pediatric Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.|Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Gregorio P
authors.initials: GP
authors.lastname: Milani
authors.affiliation: Department of Pediatrics of Southern Switzerland, Bellinzona, Switzerland.|Università della Svizzera Italiana, Lugano, Switzerland.
authors.forename: Mario G
authors.initials: MG
authors.lastname: Bianchetti
authors.affiliation: Department of Pediatrics of Southern Switzerland, Bellinzona, Switzerland.|Università della Svizzera Italiana, Lugano, Switzerland.
authors.forename: Giacomo D
authors.initials: GD
authors.lastname: Simonetti
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage*; D000285:Administration, Rectal; D058633:Antipyretics / Q000008:administration & dosage*; D005260:Female; D005334:Fever / Q000188:drug therapy*; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D007223:Infant; D007558:Italy; D007802:Language; D008297:Male; D011795:Surveys and Questionnaires; D013557:Switzerland
chemical_list: D058633:Antipyretics; D000082:Acetaminophen; D007052:Ibuprofen