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Paediatric Fever Management Practices and Antipyretic Use Among Doctors and Nurses in Australian Emergency

Anastasia Mutic1, Rui Zhi Tan1, Eunicia Tan2,3

  • 1Department of Paediatrics, Monash University, Clayton, Victoria, Australia.

Emergency Medicine Australasia : EMA
|November 3, 2025
PubMed

Insights

Less than 10% of Australian emergency department clinicians follow international guidelines for pediatric fever management. Practice varied significantly between specialist and general departments, with lower adherence in specialist settings.

Area of Science:

  • Emergency Medicine
  • Pediatric Care
  • Clinical Practice Guidelines

Background:

  • International guidelines exist for managing pediatric fever, focusing on alleviating distress with antipyretic monotherapy.
  • Adherence to these guidelines among Australian Emergency Department (ED) clinicians is not well-documented.
  • Understanding practice variations is crucial for improving pediatric fever management.

Purpose of the Study:

  • To assess the adherence of Australian ED clinicians to international clinical guidelines for pediatric fever management.
  • To identify variations in practice between different types of EDs and between medical and nursing staff.

Main Methods:

  • A cross-sectional survey was conducted across 22 Australian EDs.
  • Clinical vignettes were used to evaluate compliance with guidelines for treating pediatric fever.
  • Respondents included doctors and nurses, with comparisons made between specialist pediatric EDs and general EDs.

Main Results:

  • Only 9.3% of 539 surveyed clinicians adhered to evidence-based guidelines for pediatric fever treatment.
  • Clinicians in specialist pediatric EDs showed less than half the adherence rate of those in general EDs (5.4% vs. 12.4%).
  • Nearly half of respondents (46.8%) endorsed combined antipyretic therapy, and many would use antipyretics for temperature reduction (84.0%) or decreased fluid intake (87.5%).

Conclusions:

  • Adherence to international consensus recommendations for pediatric fever management among Australian ED clinicians is low, with fewer than 10% reporting consistent practice.
  • Significant variations in practice exist, particularly between specialist pediatric and general EDs.
  • Current practices often deviate from evidence-based guidelines, highlighting a need for improved education and implementation strategies.
Abstract

Keywords:
antipyreticschildemergency departmentsfebrilefever

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