Pediatricians left guessing at drug doses

Is it really a guessing game?

Well, sometimes.

The crux of the article is for the over the counter cold relief medicines, of which there really are no established dosing guidelines. For those the doses really are a guess, so I for one have no problem with them being off the market.

Most newer prescription medications tend to not be tested in children initially, but then if they are used "off label" for a number of years in kids the drug companies will attempt to get pediatric indications.

That "off label" dose is determined by a number of factors, as the article states:

"Infants may require significantly less of a medication than adults, not only because of their weight, but also because their liver and kidneys are not mature. Older children sometimes metabolize drugs at a faster rate than adults, so they may need more of a particular drug. In other words, children are not just little adults."

It has been my experience that usually the sub-specialists (pediatric cardiologists, neurologists, etc) start to use medications off label and then that information sort of trickles down to those of us in the trenches, so to speak.

Honestly, the vast majority of commonly used pediatric medications have established dosing guidelines.