万古霉素是治疗革兰阳性菌感染，尤其是耐甲氧西林金黄色葡萄球菌感染的关键糖肽类抗生素。然而，儿科患者显著的药代动力学异质性导致传统给药方案较难平衡儿童患者的疗效与肾毒性风险。模型引导的精准用药（MIPD）策略通过整合定量药理学模型（如PPK、PBPK及机器学习模型）与患者个体数据，为实现基于24小时药时曲线下面积与最低抑菌浓度比值（AUC_0-24h/MIC）的个体化治疗提供了新途径。MIPD策略相较于传统治疗药物监测（TDM），能显著提升药代动力学/药效学靶标的达标率，尤其在新生儿和重症患者中可缩短达标时间，同时有效降低肾毒性风险。本文综述了MIPD策略在新生儿、重症患儿及特殊疾病儿童中指导万古霉素应用的临床价值，以期为临床精准用药提供参考。

Vancomycin is a key glycopeptide antibiotic for the treatment of Gram-positive bacterial infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA). However, significant pharmacokinetic (PK) heterogeneity in pediatric patients makes it difficult for traditional dosing regimens to balance efficacy and nephrotoxicity risk. Model-Informed precision dosing (MIPD) strategies provide a novel approach for individualized, AUC_0-24h/MIC-guided therapy by integrating quantitative pharmacological models (such as PPK, PBPK, and machine learning models) with individual patient data. Compared to conventional TDM, MIPD strategies significantly enhance the attainment rate of pharmacokinetic/pharmacodynamic (PK/PD) target concentrations (e.g., AUC), shorten the time to target attainment, especially in neonates and critically ill patients, and effectively reduce the risk of nephrotoxicity. This review summarizes the clinical value of MIPD-guided vancomycin application in neonates, critically ill children, and children with special disease conditions, intending to provide a reference for clinical practice.