<p>Prescription patterns of analgesics, antipyretics, and non steroidal anti-inflammatory drugs for the management of fever and pain in pediatric patients: a cross-sectional, multicenter study in Latin America, Africa, and the Middle East</p>

Abstract

Objective To evaluate the daily practice of pediatricians, physician-perceived reasons for unsatisfactory effects of treatment, and unmet needs in the management of acute pain and/or fever. Methods This was a multinational (n=13), multicenter, non interventional, cross-sectional study conducted in Latin America, Africa, and the Middle East in children under 16 years of age with fever (defined as a central body temperature ≥38°C) and/or acute pain (defined as pain lasting ≤6 weeks). Data were collected during a single visit using a structured physician-administered questionnaire and case report forms. Results A total of 2125 patients were recruited by 178 physicians between September 2010 and September 2011. From the 2117 analyzed patients, 1856 (87.7%) had fever, 705 (33.3%) had acute pain, and 446 (21.1%) had both. Of 1843 analyzed patients with fever, 1516 (82.3%) were previously prescribed a pharmacological treatment for the management of fever concomitantly with a non pharmacological approach, while 1817/1856 patients (97.9%) were currently receiving a prescribed pharmacological treatment for fever. Paracetamol/acetaminophen was the most commonly prescribed antipyretic medication during both previous (70.8%) and current (64.1%) consultations. With regard to acute pain management, 67.2% of the patients received previous and 93.9% received current treatment for pain. The most frequently prescribed analgesic during previous consultations was paracetamol/acetaminophen (53.7%), and the current most commonly prescribed analgesics were non steroidal anti-inflammatory drugs (55.2%). Treatment patterns for patients with both fever and acute pain were similar. Overall, 53.4% of the physicians reported poor treatment compliance as a reason for the unsatisfactory effect of the pain/fever treatment, and the most common unmet need was the availability of new drugs (according to 63.5% of the physicians). Conclusions Adequate management of fever was observed; however, due to the complex etiology of pediatric pain, better evaluation and management of pain in pediatrics is necessary.

Determinants of caregiver's knowledge and practices regarding childhood fever management in a developing setting: a multi-centre cross-sectional assessment

“…The youngest age group (≤3 years) constituted the highest number of febrile patients presenting at our study centers and this is consistent with the findings of Escalante and collaborators who assessed the antipyretic prescription pattern among 1,856 febrile children presenting at the health facilities of 13 developing countries spread across three WHO regions (42). This might have caused a lot of parental anxiety or fever phobia among the surveyed caregivers, especially for those in Africa and Asia due to their disproportionately high under-5 mortality rate (8,42); especially in the presence of malnutrition (undernutrition) as was recorded in our study (43).…”

Comparison of Dexibuprofen Versus Ibuprofen as an Antipyretic in Febrile Children- A Randomized Clinical Trial

“…4 In case of infection along with adequate antibiotics, antipyretics are routinely prescribed for symptomatic relieve of fever. 5 Paracetamol and iburprofen are commonly used analgesics for febrile children due to their overall safety profile, high efficacy and less cost. 6 Ibuprofen has been improved by producing its racemic enantiomer called dexibuprofen.…”

The hematological and histological studies for the hepatoprotective-like effect of the hydromethanolic extract and the fractions of Viola serpens Wall.

“…Toxic metabolites are the results of about 62% of withdrawn drugs administration. PCM is a commonly used analgesic and antipyretic drug that results in acute centrilobular necrosis and centrizonalheamorrhagic (25,26). Similarly, 90-95% PCM metabolism occurs through the liver and was excreted through the kidneys (27,28).…”