National modulators of symptomatic fever management in children : comparative analysis of survey data

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.