[Fever in children and adolescents in otorhinolaryngology : Practical overview based on the German S3 guideline]

Fever is an important symptom in pediatric ear, nose, and throat (ENT) infections. The current German S3 guideline, "Fever Management in Children and Adolescents," addresses the management of acute fever in otherwise healthy children and adolescents in an outpatient setting.

The aim of this article is to summarize the key statements of the S3 guideline on fever management and to assess their practical relevance to the field. The focus is on clinical assessment, temperature measurement, symptom-oriented therapy, parental counseling, and rational antibiotic use.

A narrative review was conducted based on the current "Fever management in children and adolescents" S3 guideline from the Association of the Scientific Medical Societies in Germany (AWMF), with particular consideration of ENT-relevant clinical situations and related topics such as earache, sore throat, and rhinosinusitis.

The assessment of feverish children depends not only on temperature readings, but above all on their general condition, warning signs, and clinical context. In children over 1 year of age, tympanic temperature measurement is considered sufficiently accurate in most cases, while axillary measurement is not recommended for reliable temperature determination. When fever is rising, with cold hands and feet or shivers, children and youths should be cared for and covered according to their need for warmth. Antipyretics can be used to alleviate discomfort and pain-not solely to lower the temperature. They are not suitable for preventing febrile seizures. Antibiotics should be prescribed restrictively, rationally, and in accordance with guidelines, as fever itself is not an indication for antibiotics.

These recommendations support a structured, cautious, and safety-oriented approach to febrile children. In addition to recognizing warning constellations, clear caregiver counselling, symptom-based treatment, and consistent antibiotic stewardship are key elements of care.