Abstract
Background. Fever in children is common and mostly caused by self-limiting infections. However,
parents of febrile children often consult in general practice, in particular during out-of-hours care. To
improve management, it is important to understand experiences of GPs managing these consultations.
Objective. To describe GPs’ experiences regarding management of childhood fever during out-ofhours
care.
Methods. A descriptive qualitative study using purposeful sampling, five focus group discussions were
held among 37 GPs. Analysis was based on constant comparative technique using open and axial coding.
Results. Main categories were: (i) Workload and general experience; (ii) GPs’ perceptions of
determinants of consulting behaviour; (iii) Parents’ expectations from the GP’s point of view; (iv)
Antibiotic prescribing decisions; (v) Uncertainty of GPs versus uncertainty of parents and (vi)
Information exchange during the consultation. GPs felt management of childhood fever imposes
a considerable workload. They perceived a mismatch between parental concerns and their
own impression of illness severity, which combined with time–pressure can lead to frustration.
Diagnostic uncertainty is driven by low incidences of serious infections and dealing with parental
demand for antibiotics is still challenging.
Conclusion. Children with a fever account for a high workload during out-of-hours GP care which
provides a diagnostic challenge due to the low incidence of serious illnesses and lacking longterm
relationship. This can lead to frustration and drives antibiotics prescription rates. Improving
information exchange during consultations and in the general public to young parents, could help
provide a safety net thereby enhancing self-management, reducing consultations and workload,
and subsequent antibiotic prescriptions.