Table 2.
Fever management by healthcare providers.
| Question | Multiple Choice Answers | Total n = 378 |
Primary care Pediatricians n = 144 |
Hospital Pediatricians n = 98 |
Pediatric Residents n = 62 |
Pediatric Nurses n = 74 |
p-Value |
|---|---|---|---|---|---|---|---|
| n (%) | n (%) | n (%) | n (%) | n (%) | |||
| What type of thermometer do you recommend to your patients? | Mercury | 70 (18.52) | 29 (20.14) | 26 (26.53) | 4 (6.45) | 11 (14.86) | 0.004 |
| Infra-red | 24 (6.35) | 11 (7.64) | 5 (5.1) | 2 (3.23) | 6 (8.11) | ||
| Liquid crystals | 33 (8.73) | 19 (13.19) | 8 (8.16) | 3 (4.84) | 3 (4.05) | ||
| Electronic | 267 (70.63) | 99 (68.75) | 61 (62.24) | 53 (85.48) | 54 (72.97) | ||
| Gallium rectal thermometer | 4 (1.06) | 3 (2.08) | 1 (1.02) | 0 (0) | 0 (0) | ||
| NA | 18 (4.76) | 8 (5.56) | 9 (9.18) | 1 (1.61) | 0 (0) | ||
| What site do you suggest for measuring a child’s temperature? | Rectum | 99 (26.19) | 61 (42.36) | 24 (24.49) | 1 (1.61) | 13 (17.57) | <0.001 |
| Armpit | 266 (70.37) | 94 (65.28) | 65 (66.33) | 50 (80.65) | 57 (77.03) | ||
| Ear | 34 (8.99) | 9 (6.25) | 13 (13.27) | 10 (16.13) | 2 (2.7) | ||
| Forehead | 10 (2.65) | 3 (2.08) | 1 (1.02) | 2 (3.23) | 4 (5.41) | ||
| Groin | 2 (0.53) | 2 (1.39) | 0 (0) | 0 (0) | 0 (0) | ||
| It depends on the child’s age | 19 (5.03) | 5 (3.47) | 5 (5.1) | 3 (4.84) | 6 (8.11) | ||
| NA | 3 (0.79) | 1 (0.69) | 2 (2.04) | 0 (0) | 0 (0) | ||
| In your opinion, the word “fever” describes what temperature? | It depends on the child’s age | 19 (5.03) | 10 (6.94) | 5 (5.1) | 1 (1.61) | 3 (4.05) | 0.257 |
| Axillary ≥ 37.9° | 203 (53.7) | 74 (51.39) | 63 (64.29) | 32 (51.61) | 34 (45.95) | ||
| Axillary ≥ 38.5° | 103 (27.25) | 37 (25.69) | 20 (20.41) | 19 (30.65) | 27 (36.49) | ||
| Other | 51 (13.49) | 22 (15.28) | 11 (11.22) | 9 (14.51) | 9 (12.16) | ||
| NA | 7 (1.85) | 3 (2.08) | 0 (0) | 2 (3.23) | 2 (2.7) | ||
| What antipyretic do you administer most frequently? | Oral paracetamol | 311 (82.28) | 119 (82.64) | 87 (88.78) | 50 (80.65) | 55 (74.32) | 0.022 |
| Rectal paracetamol | 98 (25.93) | 33 (22.92) | 17 (17.35) | 14 (22.58) | 34 (45.95) | ||
| Oral ibuprofen | 11 (2.91) | 7 (4.86) | 3 (3.06) | 1 (1.61) | 0 (0) | ||
| Intravenous paracetamol | 2 (0.53) | 0 (0) | 0 (0) | 0 (0) | 2 (2.7) | ||
| NA | 1 (0.26) | 1 (0.69) | 0 (0) | 0 (0) | 0 (0) | ||
| If you prescribe paracetamol more frequently than ibuprofen, why do you do so? | Better tolerability with equal efficacy | 273 (72.99) | 112 (80) | 79 (80.61) | 55 (88.71) | 27 (36.49) | <0.001 |
| Better tolerability and greater efficacy | 30 (8.02) | 8 (5.71) | 10 (10.2) | 6 (9.68) | 6 (8.11) | ||
| Better tolerability with less efficacy | 4 (1.07) | 2 (1.43) | 1 (1.02) | 0 (0) | 1 (1.35) | ||
| Other | 16 (4.28) | 10 (7.14) | 6 (6.12) | 0 (0) | 0 (0) | ||
| NA | 55 (14.55) | 12 (8.33) | 2 (2.04) | 1 (1.61) | 40 (54.05) | ||
| If you prescribe ibuprofen more frequently than paracetamol, why do you do so? | Equal tolerability and greater efficacy | 3 (27.27) | 2 (28.57) | 1 (33.33) | 0 (0) | 0 (0) | 1 |
| Better anti-inflammatory drug | 1 (9.09) | 1 (14.29) | 0 (0) | 0 (0) | 0 (0) | ||
| NA | 374 (98.94) | 141 (97.91) | 97 (98.97) | 62 (100.0) | 74 (100.0) | ||
| What dose of paracetamol do you use? | 10–15 mg/kg/dose up to a maximum of 90 | 205 (54.23) | 82 (56.94) | 63 (64.29) | 41 (66.13) | 19 (25.68) | <0.001 |
| 10–15 mg/kg/dose up to a maximum of 120 | 29 (7.67) | 17 (11.81) | 6 (6.12) | 4 (6.45) | 2 (2.7) | ||
| 10 mg/kg/dose per os and 20 mg/kg/dose rectally | 81 (21.43) | 43 (29.86) | 25 (25.51) | 12 (19.35) | 1 (1.35) | ||
| Other | 310 (82.01) | 140 (97.22) | 91 (92.86) | 57 (91.94) | 22 (29.73) | ||
| NA | 51 (13.49) | 1 (0.69) | 6 (6.12) | 4 (6.45) | 40 (54.05) | ||
| What dose of ibuprofen do you use? | 5–10 mg/kg/dose up to a maximum of 60 | 200 (52.91) | 82 (56.94) | 61 (62.24) | 42 (67.74) | 15 (20.27) | <0.001 |
| 5–10 mg/kg/dose up to a maximum of 120 | 16 (4.23) | 8 (5.56) | 6 (6.12) | 1 (1.61) | 1 (1.35) | ||
| 5–10 mg/kg/dose per os up to a maximum of 20 mg/kg/dose | 28 (7.41) | 16 (11.11) | 8 (8.16) | 4 (6.45) | 0 (0) | ||
| 5–10 mg/kg/dose up to a maximum of 30 mg/kg/dose | 10 (2.65) | 0 (0) | 6 (6.12) | 4 (6.45) | 0 (0) | ||
| Other | 22 (5.82) | 10 (6.94) | 0 (0) | 2 (3.23) | 10 (13.51) | ||
| NA | 104 (27.51) | 28 (19.44) | 19 (19.39) | 9 (14.52) | 48 (64.86) | ||
| Do you suggest alternating the administration of ibuprofen and paracetamol? | No | 302 (79.89) | 126 (87.5) | 73 (74.49) | 54 (87.1) | 49 (66.22) | 0.090 |
| Yes | 58 (15.34) | 17 (11.81) | 23 (23.47) | 8 (12.9) | 10 (13.51) | ||
| NA | 18 (4.76) | 1 (0.69) | 2 (2.04) | 0 (0) | 15 (20.27) | ||
| In your opinion, what is the main side effect of paracetamol? | Gastritis | 10 (2.65) | 3 (2.08) | 4 (4.08) | 1 (1.61) | 2 (2.7) | 0.012 |
| Hepatotoxicity | 326 (86.24) | 119 (82.64) | 87 (88.78) | 58 (93.55) | 62 (83.78) | ||
| Other | 28 (7.41) | 19 (13.19) | 5 (5.1) | 3 (4.84) | 1 (1.35) | ||
| NA | 21 (5.56) | 9 (6.25) | 3 (3.06) | 0 (0) | 9 (12.16) | ||
| In your opinion, what is the main side effect of ibuprofen? | Gastritis or gastrointestinal bleeding | 261 (69.05) | 106 (73.61) | 64 (65.31) | 49 (79.03) | 42 (56.76) | 0.003 |
| Renal insufficiency | 87 (23.02) | 27 (18.75) | 23 (23.47) | 15 (24.19) | 22 (29.73) | ||
| Other | 41 (10.85) | 26 (18.06) | 9 (9.18) | 2 (3.23) | 4 (5.41) | ||
| NA | 31 (8.2) | 11 (7.64) | 8 (8.16) | 2 (3.23) | 10 (13.51) |
The correct answers according to the Italian Pediatric Society’s guidelines for the management of fever and the significant p-values are written in bold.