Despite the need for effective vancomycin therapy, there are few data guiding vancomycin monitoring in children. We reviewed retrospectively vancomycin use in children 1 month to 12 years of age. Initial and adjusted target trough vancomycin concentrations in serum were infrequently achieved regardless of the dosing schedule. Currently recommended trough concentrations need to be re-examined with a more detailed pharmacokinetic study in children.