gms | German Medical Science

Background: Fever in children is one of the most common clinical symptoms treated by pediatricians [1]. Fever is also a common cause of parental distress [2]. Many parents give antipyretics even without any warning signs, because they believe that the child must maintain a “normal” temperature. However, fever is not the disease, but a physiological mechanism that has a positive effect on infection control. According guidelines the regular use of antipyretics by parents is often inadequate.

In Germany, no data were available on the exact parental administration behaviour in the case of a febrile child. Representative data on fever treatment in children are needed for comparision with a new established fever registry (https://www.feverapp.de/).

Methods: A survey with 1000 private households in Germany in which one or more children under the age of 18 live has been initiated by the Federal Association of German Pharmacists' Associations (ABDA). It was conducted on a nationwide representative basis from February to March 2019 under the title “Children and Drugs”. Computer-assisted telephone interviews were evaluated using a structured questionnaire under the systematic random selection (multi-level stratified sample) plus final quota question with +/- 3 percentage points in the overall sample. As a specific research question, parents were asked: Has your child taken drugs to reduce fever in the last 12 months?

Results: During the last year, 45% of the parents took antipyretic drugs. Parents who gave antipyretic drugs more often (p<0.001) were a.) those parents who gave their child any drugs at all in the last four weeks (53% vs. 33%), b.) those who were supervised by a pediatrician instead of a general practitioner (51% vs. 32%) and c.) those who went to the doctor or pharmacy more often at all. Drug-induced fever reduction was clearly highest at the age of 3-6 years with 76%, at the age of under three years it was 68%, at primary school age 52%, at puberty 37% and at teenagers 29%. Gender and place of residence had no influence, fever reduction occurred somewhat more often (p=0.034) among privately insured (52%) and families with higher income (55%, p=0.001). Especially younger parents under 35 years of age (64%) tend to take medication to reduce fever, compared to those over 45 years of age (35%). Ibuprofen was used in 71% of cases, acetaminophen in 29%.

Conclusion: In comparision to the results of a study from Turkey [3], the use of antipyretic drugs was equally frequent. In contrast, the figures from a survey in Australia [4] were twice as high as in Germany and the use of acetaminophen was more often than of ibuprofen. In contrast, antipyretic drugs were administered less often in Palestine [5] than in Germany.

Almost half of all German parents lower their children's fever with medication, although this is physiologically unfavourable.

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.