{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T15:00:24Z","timestamp":1777993224341,"version":"3.51.4"},"reference-count":31,"publisher":"Aboutscience Srl","issue":"1","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Grhta"],"abstract":"<jats:p>Background: Paracetamol and ibuprofen are widely used for fever and pain in children, but real-world prescribingoften deviates from guidelines, leading to potentially avoidable complications and healthcare costs.Objectives: To estimate the clinical and economic burden associated with inappropriate use of paracetamol andibuprofen in Italian pediatric care and to identify high-risk clinical scenarios in which safer prescribing may reducecomplications.Methods: A retrospective analysis was conducted on national hospital discharge records (2010-2016), focusingon DRGs and ICD-9-CM codes linked to adverse events following antipyretic or NSAID use in children aged 0-17. Aqualitative assessment was also carried out through expert consultation to contextualize findings.Results: Among 999,739 hospital discharges, 4,308 cases (0.43%) developed complications within three years.ENT procedures and renal diagnoses showed the highest complication rates and costs. Children under three accounted for the largest share of healthcare expenditure. A scenario analysis using pneumonia data suggestedthat up to 3,000 complications and \u20ac10 million in costs could be avoided with more selective NSAID use. Expertsrecommended prioritizing paracetamol in high-risk scenarios, including dehydration, respiratory infections, andvaricella.Conclusions: Inappropriate use of antipyretics in pediatric care is associated with a measurable clinical andfinancial burden. Greater adherence to prescribing recommendations, especially in vulnerable populations, canimprove outcomes and reduce costs. Educating caregivers and harmonizing clinical practices are key priorities.<\/jats:p>","DOI":"10.33393\/grhta.2025.3579","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T07:04:55Z","timestamp":1759907095000},"page":"227-233","source":"Crossref","is-referenced-by-count":2,"title":["Optimising pediatric paracetamol and ibuprofen use: a retrospective study with expert evaluation of efficacy, safety, and healthcare costs"],"prefix":"10.33393","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3974-3798","authenticated-orcid":false,"given":"Andrea","family":"Marcellusi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Ragonese","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"D'Avino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Taglialatela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Lo Vecchio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"18642","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"17729","doi-asserted-by":"crossref","unstructured":"Chiappini E, Bortone B, Galli L, et al. Guidelines for the symptomatic management of fever in children: systematic review of the literature and quality appraisal with AGREE II. BMJ Open. 2017;7(7):e015404. https:\/\/doi.org\/10.1136\/bmjopen-2016-015404 PMID:28760789","DOI":"10.1136\/bmjopen-2016-015404"},{"key":"17730","doi-asserted-by":"crossref","unstructured":"Pantell RH, Roberts KB, Adams WG, et al.; SUBCOMMITTEE ON FEBRILE INFANTS. Evaluation and management of well-appearing febrile infants 8 to 60 days old. Pediatrics. 2021;148(2):e2021052228. https:\/\/doi.org\/10.1542\/peds.2021-052228 PMID:34281996","DOI":"10.1542\/peds.2021-054063"},{"key":"17731","doi-asserted-by":"crossref","unstructured":"Chiappini E, Venturini E, Remaschi G, et al.; Italian Pediatric Society Panel for the Management of Fever in Children. 2016 Update of the Italian Pediatric Society Guidelines for management of fever in children. 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