Abstract: OBJECTIVE To evaluate the pharmacodynamics and safety of two commonly used dosages of vancomycin on treatment of children and determine the optimal trough concentration so as to provide guidance for reasonable clinical use and surveillance of vancomycin. METHODS The children who were treated with 40 mg/(kg·d) of vancomycin (the low-dose group) or 60 mg/(kg·d) of vancomycin (the high-dose group) and received the surveillance of blood concentrations from Jul 2012 to Dec 2014 were recruited as the study objects, then the adverse reactions in the children were observed, the AUC_{0-24 h} was calculated by means of population pharmacokinetics model, and the statistical analysis of data was performed with the use of SPSS18.0 software. RESULTS The mean AUC_{0-24 h} was (326.7±284.5) mg·h/L in the low-dose group, (472.3±399.1) mg·h/L in the high-dose group, and there was significant difference (P＜0.05).The children with the AUC_{0-24 h} more than 400 mg·h/L accounted for 21.7% in the low-dose group and accounted for 56.7% in the high-dose group.There was no significant difference in the incidence of adverse reactions between the two groups of children.The trough concentration was highly correlated with the AUC_{0-24 h}, when the trough concentration was 10 mg/L, the AUC_{0-24 h} was more than 400 mg·h/L for all the children. CONCLUSION As compared with the starting dose of 40 mg/(kg·d), the initial dose of vancomycin 60 mg/(kg·d) can achieve more significant effect on treatment of the children without the increase of incidence of adverse reactions.When the MIC is no more than 1 mg/L and the trough concentration is 10 mg/L, the target AUC_{0-24 h}/MIC>400 mg·h/L can be achieved.