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Vancomycin dosage requirements were studied in six young burn patients, in whom initial doses ordered by house officers were monitored using peak and trough vancomycin serum concentration measurements. Dosage regimens were adjusted to produce peak and trough levels within the recommended range of 30 to 40 mg/L and 5 to 10 mg/L, respectively. Vancomycin dosages and serum levels were compared initially and after dosage adjustment, and with the manufacturer's recommended doses, the data suggested that current manufacturer's recommendations are too conservative for optimal dosage of vancomycin in young burn patients. We suggest dosage regimens of 60 mg/kg/day in divided doses in this patient population, dosing intervals to be determined by peak and trough vancomycin serum concentration measurement.