Chiappini Elena, Bestetti Matilde, Masi Stefano, Paba Teresa, Venturini Elisabetta, Galli Luisa
Pediatric Infectious Disease Unit, Anna Meyer Children's University Hospital, Florence, Italy.
Department of Health Sciences, University of Florence, Florence, Italy.
Front Pediatr. 2023 Mar 9;11:1075449. doi: 10.3389/fped.2023.1075449. eCollection 2023.
international guidelines recommend treating fever in children not at a predefined body temperature limit but based on the presence of discomfort. However few studies evaluated discomfort relief after administration of antipyretics in children.
Between 1st January and 30th September 2021 a single-center prospective observational study was performed in febrile children consecutively admitted to a pediatric emergency department and treated with paracetamol orally. For each child, body temperature, presence and severity of discomfort, defined using a previously published semiquantitative likert scale, were evaluated at baseline and 60 min after administration of paracetamol, and differences were analyzed.
172 children (males: 91/172; 52.9%; median age: 41.7 months) were included. Significant reductions in body temperature (median body temperature at T0: 38.9 °C; IQR: 38.3-39.4, median body temperature at T60: 36.9 °C; IQR: 36.4-37.5; < 0.0001), and in the level of discomfort (proportion of children with severe discomfort at T0: 85% and at T60:14%; < 0.0001) were observed. Severe discomfort at T60 persisted in a minority of children (24/172; 14%) and it was not related to body temperature values.
paracetamol in febrile children is associated not only with significantly reduction in body temperature but also with discomfort relief.
国际指南建议，儿童发热治疗不应基于预先设定的体温界限，而应根据是否存在不适来决定。然而，很少有研究评估儿童服用退烧药后不适症状的缓解情况。
2021年1月1日至9月30日，在一家儿科急诊科对连续收治的发热儿童进行了一项单中心前瞻性观察研究，这些儿童口服对乙酰氨基酚进行治疗。对于每个儿童，在基线时以及服用对乙酰氨基酚60分钟后，使用先前发表的半定量李克特量表评估体温、不适的存在和严重程度，并分析差异。
纳入172名儿童（男性：91/172；52.9%；中位年龄：41.7个月）。观察到体温显著降低（T0时中位体温：38.9°C；四分位间距：38.3 - 39.4，T60时中位体温：36.9°C；四分位间距：36.4 - 37.5；<0.0001），不适程度也显著降低（T0时严重不适儿童比例：85%，T60时：14%；<0.0001）。少数儿童（24/172；14%）在T60时仍存在严重不适，且与体温值无关。
发热儿童服用对乙酰氨基酚不仅能显著降低体温，还能缓解不适。
