Abstract: Reports have shown that there has been increased prevalence of community-acquired methicillin-resistant Staphylococcus aureus（CA-MRSA） pneumonia. The factors such as CA-MRSA strain gene mutation，MIC drift，and antimicrobial resistance have increased the challenge for pediatricians in empirical treatment of CA-MRSA infections.Vancomycin is the first-line antibiotic for MRSA infection，which has the characteristics of narrow therapeutic window and nephrotoxicity.Based on individualized pharmacokinetics and pharmacodynamics （PK/PD） and therapeutic drug concentration monitoring （TDM），and under different pathophysiological state of the children，individualized treatment with vancomycin for the patients with CA-MRSA pneumonia can increase the safety and effectiveness，and reduce the prodution of drug-resistant bacteria.

Key words: child, community-acquired methicillin-resistant Staphylococcus aureus, pneumonia, vancomycin

摘要： 社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）肺炎患病率报道增多。CA-MRSA菌株基因突变、MIC漂移、抗菌药物耐药性增加等因素使儿科医师在经验性治疗CA-MRSA肺炎时面临重大挑战。万古霉素是抗MRSA感染的一线抗菌药物，具有治疗窗窄及肾脏毒性等特点。患儿在不同病理生理状态下，以药代动力学与药效学（PK/PD）原理及治疗药物浓度监测（TDM）为指导，进行万古霉素个体化治疗，可提高CA-MRSA肺炎患儿使用万古霉素的安全性和有效性，并减少耐药菌株产生。

关键词: 儿童, 社区获得性耐甲氧西林金黄色葡萄球菌, 肺炎, 万古霉素