Background: Glucocorticoids are potent suppressors of immunity, whereas pyrazolone analgesics cause agranulocytosis that can result in severe infection.Recently, severe enterovirus 71 and influenza infections were epidemiologically associated with using these drugs to treat fever during early, mild illness from these infections.To better understand risk when these drugs were used as antipyreties poses to the population, we conducted a survey in Dongkou County during October 2010.Methods: We selected from the county all 20 township hospitals and a random sample of 58 village clinics from all 594 village clinics.We reviewed outpatient clinic records of all patients who had febrile illness diagnosis during March-July 2010.We interviewed the doctors about reasons for using pyrazolones and glucocorticoids as antipyretics.We accounted for the complex sample design in the data analysis.Results: Of 3481 records, 589 (40%, 95% confidence interval [CI]: 37%-42%) of township hospitals and 931 (47%, 95% CI: 46%-47%) of village clinics used pyrazolone injections.135 (51%, 95% CI: 49%-53%) of patients with low-grade fever (<38C) and 427 (52%, 95% CI: 51%-53%) of children aged 0-5 years received pyrazolones in village clinics.484 (33%, 95% CI: 30%-35%) of township hospitals and 561 (28%, 95% CI: 27%-29%) of village clinics used dexamethasone.51% (95% CI: 42%-61%) of 88 doctors interviewed customarily used pyrazolones for fever treatment.The main reasons of using the drugs were fast effect (93%), relieving symptoms (56%) and being cheap (3.7%).Conclusions: Pyrazolones and dexamethasone were used extensively in township hospitals and village clinics to treat fever.To prevent severe infections and other side-effects from these drugs, we recommended banning their use for fever treatment from mild infections in outpatient settings.