Paracetamol use in pediatric fever: a cross-sectional survey of clinicians in India
DOI:
https://doi.org/10.18203/2349-3291.ijcp20261910Keywords:
Paracetamol, Paediatric fever, Antipyretic therapy, Treatment preferences, Gastrointestinal safety, Clinical surveyAbstract
Background: Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in pediatric patients. However, clinicians’ preferences and perspectives regarding their safety and efficacy may vary in clinical practice. This survey aimed to assess the clinical practices and perceptions regarding the use of paracetamol in the management of fever in pediatric patients in India.
Methods: This cross-sectional study was conducted among clinicians managing febrile pediatric patients across India. A structured 22-item questionnaire was administered covering antipyretic agent selection, formulation preferences, comparative safety of paracetamol versus NSAIDs, adverse drug reactions, and clinician-rated efficacy on a five-point global improvement scale. Data were analyzed using descriptive statistics, with categorical variables expressed as frequencies and percentages.
Results: The survey included 506 practitioners. Most clinicians reported initiating fever management with paracetamol or NSAIDs (87%), and nearly all (98%) preferred paracetamol as the antipyretic of choice in children. A large proportion (81%) preferred paracetamol as the initial step in 21-30% of patients, while 52% used suppositories in fewer than 10% of febrile cases. Fewer gastrointestinal side effects were identified as the main advantage of paracetamol syrup or drops over ibuprofen by 44% of clinicians, and 57% considered paracetamol to have a better gastrointestinal safety profile. Most clinicians had not encountered adverse drug reactions with paracetamol (86%), and 55% rated its efficacy as showing marked improvement on the global improvement scale.
Conclusions: Paracetamol is the most commonly preferred first-line antipyretic among clinicians for pediatric fever management in India. It is widely regarded as having a favorable gastrointestinal safety profile compared with ibuprofen, a low burden of adverse drug reactions, and good clinician-rated efficacy.
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