Tags

Type your tag names separated by a space and hit enter

Management of fever in children: summary of the Italian Pediatric Society guidelines.
Clin Ther. 2009 Aug; 31(8):1826-43.CT

Abstract

OBJECTIVE

This article summarizes the Italian Pediatric Society guideline on the management of the signs and symptoms of fever in children, prepared as part of the National Guideline Program (NGLP).

METHODS

Relevant publications in English and Italian were identified through searches of MEDLINE and the Cochrane Database of Systematic Reviews from their inception through December 31, 2007. Based on the consensus of a multidisciplinary expert panel, the strength of the recommendations was categorized into 5 grades (A-E) according to NGLP methodology.

SUMMARY

In the health care setting, axillary measurement of body temperature using a digital thermometer is recommended in children aged <4 weeks; for children aged > or =4 weeks, axillary measurement using a digital thermometer or tympanic measurement using an infrared thermometer is recommended. When body temperature is measured at home by parents or care-givers, axillary measurement using a digital thermometer is recommended for all children. Children who are afebrile when seen by the clinician but are reported to have had fever by their caregivers should be considered febrile. In special circumstances, high fever may be a predictive factor for severe bacterial infection. Use of physical methods of reducing fever is discouraged, except in the case of hyperthermia. Use of antipyretics-paracetamol (acetaminophen) or ibuprofen-is recommended only when fever is associated with discomfort. Combined or alternating use of antipyretics is discouraged. The dose of antipyretic should be based on the child's weight rather than age. Whenever possible, oral administration of paracetamol is preferable to rectal administration. Use of ibuprofen is not recommended in febrile children with chickenpox or dehydration. Use of ibuprofen or paracetamol is not contraindicated in febrile children with asthma. There is insufficient evidence to form any recommendations concerning fever in children with other chronic conditions, but caution is advised in cases of severe hepatic/renal failure or severe malnutrition. Newborns with fever should always be hospitalized because of the elevated risk of severe disease; paracetamol may be used, with the dose adjusted to gestational age. Use of paracetamol or ibuprofen is not effective in preventing febrile convulsion or the adverse effects of vaccines.

Authors+Show Affiliations

Department of Pediatrics, University of Florence, I-50139 Florence, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19808142

Citation

Chiappini, Elena, et al. "Management of Fever in Children: Summary of the Italian Pediatric Society Guidelines." Clinical Therapeutics, vol. 31, no. 8, 2009, pp. 1826-43.
Chiappini E, Principi N, Longhi R, et al. Management of fever in children: summary of the Italian Pediatric Society guidelines. Clin Ther. 2009;31(8):1826-43.
Chiappini, E., Principi, N., Longhi, R., Tovo, P. A., Becherucci, P., Bonsignori, F., Esposito, S., Festini, F., Galli, L., Lucchesi, B., Mugelli, A., & de Martino, M. (2009). Management of fever in children: summary of the Italian Pediatric Society guidelines. Clinical Therapeutics, 31(8), 1826-43. https://doi.org/10.1016/j.clinthera.2009.08.006
Chiappini E, et al. Management of Fever in Children: Summary of the Italian Pediatric Society Guidelines. Clin Ther. 2009;31(8):1826-43. PubMed PMID: 19808142.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of fever in children: summary of the Italian Pediatric Society guidelines. AU - Chiappini,Elena, AU - Principi,Nicola, AU - Longhi,Riccardo, AU - Tovo,Pier-Angelo, AU - Becherucci,Paolo, AU - Bonsignori,Francesca, AU - Esposito,Susanna, AU - Festini,Filippo, AU - Galli,Luisa, AU - Lucchesi,Bice, AU - Mugelli,Alessandro, AU - de Martino,Maurizio, AU - ,, PY - 2009/04/20/accepted PY - 2009/10/8/entrez PY - 2009/10/8/pubmed PY - 2010/1/1/medline SP - 1826 EP - 43 JF - Clinical therapeutics JO - Clin Ther VL - 31 IS - 8 N2 - OBJECTIVE: This article summarizes the Italian Pediatric Society guideline on the management of the signs and symptoms of fever in children, prepared as part of the National Guideline Program (NGLP). METHODS: Relevant publications in English and Italian were identified through searches of MEDLINE and the Cochrane Database of Systematic Reviews from their inception through December 31, 2007. Based on the consensus of a multidisciplinary expert panel, the strength of the recommendations was categorized into 5 grades (A-E) according to NGLP methodology. SUMMARY: In the health care setting, axillary measurement of body temperature using a digital thermometer is recommended in children aged <4 weeks; for children aged > or =4 weeks, axillary measurement using a digital thermometer or tympanic measurement using an infrared thermometer is recommended. When body temperature is measured at home by parents or care-givers, axillary measurement using a digital thermometer is recommended for all children. Children who are afebrile when seen by the clinician but are reported to have had fever by their caregivers should be considered febrile. In special circumstances, high fever may be a predictive factor for severe bacterial infection. Use of physical methods of reducing fever is discouraged, except in the case of hyperthermia. Use of antipyretics-paracetamol (acetaminophen) or ibuprofen-is recommended only when fever is associated with discomfort. Combined or alternating use of antipyretics is discouraged. The dose of antipyretic should be based on the child's weight rather than age. Whenever possible, oral administration of paracetamol is preferable to rectal administration. Use of ibuprofen is not recommended in febrile children with chickenpox or dehydration. Use of ibuprofen or paracetamol is not contraindicated in febrile children with asthma. There is insufficient evidence to form any recommendations concerning fever in children with other chronic conditions, but caution is advised in cases of severe hepatic/renal failure or severe malnutrition. Newborns with fever should always be hospitalized because of the elevated risk of severe disease; paracetamol may be used, with the dose adjusted to gestational age. Use of paracetamol or ibuprofen is not effective in preventing febrile convulsion or the adverse effects of vaccines. SN - 1879-114X UR - https://www.unboundmedicine.com/medline/citation/19808142/Management_of_fever_in_children:_summary_of_the_Italian_Pediatric_Society_guidelines_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0149-2918(09)00282-3 DB - PRIME DP - Unbound Medicine ER -