Background: Symptomatic management is often all that is recommended in children with fever.  To date, only 2 nationwide surveys of paediatricians regarding their attitudes toward fever have been published.

Objective: The aim of this study was to describe the management of children with fever by paediatricians in Switzerland.

Methods: For this survey, an initial close-ended questionnaire was tested and subsequently corrected.  Between Jun 2010 and Mar 2011, an invitation was sent via electronic mail containing a link to the final version of the questionnaire.  The survey was not commercially sponsored.

Results: The questionnaire was sent to 900 paediatricians, of whom 322 (36%) responded.  A total of 96% of respondents identified 38.5C or above as the rectal temperature threshold for fever treatment, and 64% indicated that they prescribe antipyretics for the treatment of general discomfort.  A total of 95% of respondents indicated that they prescribe paracetamol (acetaminophen) as the first choice of antipyretic drug, and 91% indicated that they often prescribe ibuprofen as well.  An alternating regimen of 2 drugs and physical antipyresis were indicated as common practice by 77% and 65% of paediatricians, respectively.  Homeopathic remedies are rarely prescribed (fewer than 10% of respondents).  The most commonly prescribed routes of administration in children aged 18 months, 5 years, and 10 years were rectal (78%), oral (87%) and oral (99%), respectively.  92% of respondents indicated that they believe that an exaggerated fear of fever is common among parents, but 81% stated that they do not lower the temperature threshold for initiating pharmacological treatment exclusively to calm parents.  Most respondents (95%) indicated a belief that it is possible to educate families about the fear of fever.

Conclusions: Based on the findings from the present survey, antipyretics are often prescribed to treat the general discomfort that accompanies fever.  Nonetheless, a gap exists between available evidence and clinical practice.  Guidelines should take this fact into account.