Díez Domingo J, Burgos Ramírez A, Garrido García J, Ballester Sanz A, Moreno Carretero E
Centro de Salud de Nazaret, Valencia, Spain.
An Esp Pediatr. 2001 Dec;55(6):503-10.
To assess the frequency of the use of alternating antipyretics among Spanish pediatricians and to analyze the factors that determine this practice.
An anonymous survey of practicing pediatricians was conducted. Data on the use of antipyretics were collected. Factors related to alternating antipyretics were assessed by using multivariate correlation analyses.
Three hundred twenty-four questionnaires were reviewed. The mean age of participants was 46.4 18.6 years (29-68 years). Of the responding pediatricians, 22.5 % worked in hospitals, 87.5 % in health centres and 24.7 % in in private practice. A total of 68.8 % of pediatricians (95 % CI: 63.4-73.8 %) alternated antipyretics. The combination of ibuprofen and acetaminophen was recommended by 96.9 %. The use of alternating antipyretics was positively associated with male sex (OR: 0.535; 95 % CI: 0.296-0.967; p 0.038), with few years' experience (OR: 0.952; 95 % CI: 0.922-0.984, p 0.005), with considering ibuprofen the drug of choice (OR: 2.324; 95 % CI: 1.235-4.372; p 0.009) and with the doctor's recommendation that the antipyretic be readministered in the event of slight increases in temperature (OR: 0.529; 95 % CI: 0.310-0.901; p 0.019).
Despite the lack of scientific evidence to justify the practice, the use of alternating antipyretics is common in the treatment of febrile children. Predictive factors of this practice among pediatricians are male sex, having relatively little experience, considering ibuprofen as the drug of choice and recommending the administration of new doses of antipyretic to control mild fever.
评估西班牙儿科医生交替使用退烧药的频率,并分析决定这种做法的因素。
对执业儿科医生进行了一项匿名调查。收集了退烧药使用的数据。通过多变量相关分析评估与交替使用退烧药相关的因素。
共审查了324份问卷。参与者的平均年龄为46.4±18.6岁(29 - 68岁)。在做出回应的儿科医生中,22.5%在医院工作,87.5%在健康中心工作,24.7%从事私人执业。共有68.8%的儿科医生(95%置信区间:63.4 - 73.8%)交替使用退烧药。96.9%的医生推荐布洛芬和对乙酰氨基酚联合使用。交替使用退烧药与男性性别呈正相关(比值比:0.535;95%置信区间:0.296 - 0.967;p = 0.038),与经验年限少呈正相关(比值比:0.952;95%置信区间:0.922 - 0.984,p = 0.005),与将布洛芬视为首选药物呈正相关(比值比:2.324;95%置信区间:1.235 - 4.372;p = 0.009),以及与医生建议在体温稍有升高时重新使用退烧药呈正相关(比值比:0.529;95%置信区间:0.310 - 0.901;p = 0.019)。
尽管缺乏科学证据支持这种做法,但交替使用退烧药在发热儿童的治疗中很常见。儿科医生中这种做法的预测因素包括男性性别、经验相对较少、将布洛芬视为首选药物以及建议使用新剂量退烧药来控制低热。