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. 2021 Nov 5;181(3):1221–1231. doi: 10.1007/s00431-021-04304-8

What is Known:

• Prescribing off-label is a common practice among paediatricians, as many drugs are still not authorised for use in children.

• Some countries developed national drug formularies providing off-label dosage recommendations.

What is New:

• Comparison of published dosage recommendations in known drug handbooks and online databases show substantial differences and heterogeneity, revealing the need for harmonisation.

• The design of a tool for standardised harmonisation of dosage recommendations, based on information collected on currently applied dosages, latest scientific evidence and the approval of experts.