Expert Perspectives on Paracetamol for Managing Pediatric Febrile Illness in Indian Settings

Objective: To examine expert perspectives on the prescription practices and clinical uses of paracetamol for managing pediatric febrile illness in routine Indian healthcare settings.

Methods: The study utilized multiple-response questionnaires distributed electronically to clinicians via email or online platforms. The survey comprised 30 questions pertaining to current clinical feedback, observations, prescription practices, clinical use of paracetamol, and experiences related to pediatric febrile illness in routine clinical settings. Descriptive statistics were used to analyze the data.

Results: The study included 341 experts, and the majority (72.43%) identified upper respiratory tract infections as the most common cause of pediatric acute febrile illness. About 50.73% of physicians encountered 40-50% of pediatric patients with fever in outpatient clinics, and seizures were the most commonly reported complication (66%). Oral temperature measurement (53.08%) and digital thermometers (67%) were commonly preferred for fever assessment. Paracetamol (49.56%) and paracetamol with mefenamic acid (42.82%) were the most commonly prescribed antipyretics. Viral infections were cited as the leading cause of fever cases (71%). About 60.41% clinicians reported low incidence of hepatotoxicity due to paracetamol and refrained from prescribing N-acetylcysteine for paracetamol toxicity (63%). Majority (66.57%) of the respondents reported the paracetamol suspension to be satisfactory, with strawberry (31.09%) and mango (32.55%) being the preferred flavors among pediatric patients.

Conclusion: According to the survey results, paracetamol was favored as the first-line antipyretic, with many clinicians opting for combination therapy with mefenamic acid. Viral infections are highlighted as the primary cause of pediatric fevers. The survey also revealed positive perceptions regarding the flavor and packaging of paracetamol suspension.