Guidelines for the management of fever in children have been recently published, however “fever phobia” is still spreading. To provide information which may sustain educational interventions tailored to our population we investigated the parental and medical knowledge and management of fever in preschool children.

Fever phobia is still a major issue in paediatrics. We report knowledge of a sample of Italian paediatricians performed six years after the release of the Italian guidelines for the management of fever in children (IFG). A questionnaire, developed following the IFG recommendations and previously administered to 300 paediatricians in 2012, was proposed to all the paediatricians attending the 2015 National Congress of Practice Paediatrics, held in Florence, Italy. Changes in answers over time were analyzed. 70.2% (562/800) paediatricians returned the questionnaire. The recommended site and device for body temperature measurement in children > 1 year was correctly chosen by 89.3% of participants (vs. 80.7% of 2012 participants; P < 0.001), but with children aged less than 1 year the correct answer was selected only by the 50.3% (vs. 39.3% of 2012 participants: P < 0.001). Use of physical methods was still incorrectly recommended by 51.6% of paediatricians (vs. 63.6% in 2012; P < 0.001). Use of antipyretics according to discomfort was adopted only by 38.2% of participants, while 12.2% of them recommended alternate use of antipyretics. These proportions were substantially stable since 2012 (45 and 11% respectively), rectal administration of antipyretics only in case of vomiting was correctly recommended by 86.8% of paediatricians vs. 74.7% in 2012 (P < 0.001). Improvements in some pediatricians’ misconceptions were observed over time. However, some incorrect habits persist. Further studies are needed to better understand the “weak points” of the communication between Scientific Societies and paediatricians in order to impact everyday clinical practice.

Background: Pediculosis capitis is a worldwide health problem. One of the most important factor in effective head lice eradication is to ensure that infestation is adequately recognized and treated. Our survey investigated the knowledge and practice among primary care Italian pediatricians regarding to the prevention and treatment of head lice.Methods: The questionnaire was distributed to all the pediatricians registered at the Annual Congress of Practice in Pediatrics held in Florence, Italy, November 11–12, 2011. It includes 10 questions in a multiple choice format, and one answer for each question was provided. The questionnaire was conceived by pediatricians at the Infectious Disease Unit of the Department of Science for the Health of Woman and Child, University of Florence. Questions were designed according to the guidelines by the Italian Pediatric Society (SIP), and international guidelines, such as the Centers for Disease Control and Prevention (CDC), and the American Academy of Pediatrics (AAP).Results: Overall, 364/600 pediatricians (60.7% of physicians registered to the Congress) returned the questionnaire. The majority of them (232/364; 63,7%) believe that parents consult their primary care pediatrician only after the failure of other “remedies”. Mostly, they prescribe Malathion (116/364, 31,8%) as first line treatment. Two-hundred-fourty-three (66.7%) of participants consider creams, foams and gels the most effective formulations. Two-hundred-sixty-two of pediatricians interviewed (72.0%) suggest to repeat the treatment after one week, 37/364 (10.2%) after two weeks. The majority of the pediatricians interviewed reported that recurrences occur in less than 30% of cases (279/364; 76,6%). In their own opinion, most of recurrences are the consequence of a reinfestation in the community (259/264; 77%). Three-hundred-thirty-four (91.7%) of them have never prescribed oral therapy for the treatment of head lice. Finally, 289/364 (79.4%) pediatricians believe that no product is effective for prevention.Conclusions: This is the first study that investigates the clinical practice of family pediatricians about the management and treatment of head lice globally, the Italian pediatricians surveyed proved to be quite informed on the head lice management. However, even in a country where pediatric assistance is free for everybody, a considerable proportion of parents do not seek advice to their own family pediatrician. Therefore, educations of parents, other than continuous updating of pediatricians, may contribute to a better management of head lice in the community.