WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT
• In children antipyretic drugs should be prescribed to treat the general discomfort that accompanies fever. Nonetheless, a gap often exists between available evidence and clinical practice.
• Fever is often a cause of fear among both parents and health care providers.
• Prescription patterns of several drugs are modulated by socio-cultural factors.
WHAT THIS STUDY ADDS
• Among the main regions of Switzerland there are significant regional differences in symptomatic fever management as well as in the perceived frequency of fear of fever.
• Paediatricians active in the German speaking region less frequently differ from available recommendations than their colleagues active in the French and Italian speaking regions.
AIMS In symptomatic fever management, there is often a gap between everyday clinical practice and current evidence. We were interested to see whether the three linguistic regions of Switzerland differ in the management of fever.
METHODS A close-ended questionnaire, sent to 900 Swiss paediatricians, was answered by 322 paediatricians. Two hundred and fourteen respondents were active in the German speaking, 78 in the French speaking and 30 in the Italian speaking region.
RESULTS Paediatricians from the French and Italian speaking regions identify a lower temperature threshold for initiating a treatment and more frequently reduce it for children with a history of febrile seizures. A reduced general appearance leads more frequently to a lower threshold for treatment in the German speaking than in the French and Italian speaking areas. Among 1.5 and 5-year-old children the preference for the rectal route is more pronounced in the German than in the French speaking region. French speaking respondents more frequently prescribe ibuprofen and an alternating regimen with two drugs than German speaking respondents. Finally, the stated occurrence of exaggerated fear of fever was higher in the German and Italian speaking regions.
CONCLUSIONS Switzerland offers the opportunity to compare three different regions with respect to management of febrile children. This inquiry shows regional differences in symptomatic fever management and in the perceived frequency of exaggerated fear of fever. The gap between available evidence and clinical practice is more pronounced in the French and in the Italian speaking regions than in the German speaking region.