Purpose : The purpose of this study was to verifying the efficacy of vancomycin as the initial empirical treatment and the significancy of steroid as adjunct therapy in pediatric patients with culture-proven bacterial meningitis. Method :　Among 276 pediatric patients with culture proven in CSF from 2005 to 2014 in Department of Pediatrics, Chonbuk National University Children’s Hospital, we excluded 142 cases due to suspected contamination and 47 cases also excluded due to suspected viral meningitis. Among 87 pediatric patients with bacterial meningitis, we chose 12 cases (male: 5 female: 7) who took vancomycin as the initial empirical treatment. All cultured bacteria were susceptible to the vancomycin. We retrospectively analyzed to see the efficacy of vancomycin for cultured bacterial strains and the correlation between the dosage of steroid used as an adjunct and the effectiveness of vancomycin on treatment. Results : 7 of 12(58.3%) were responsed to vancomycin. We have found no significant correlation among the type of bacterial strains(p=0.567). Patients with bacterial meningitis by Streptococcus pneumoniae, however, were more likely to associated with encephalitis than patients with bacterial meningitis by Streptococcus agalactiae. Steroid was administered to 8 out of 12 patients. High dose steroid was maintained with 3 patients among the 8 patients. The response of vancomycin has significantly decrease in high dose steroid group(p=0.045). Patients who failed of vancomycin with high dose of steroid improved clinical manifestations after after initiation of teicoplanin Conclusion: In this study, the vancomycin response rate was barely above half. Contrary to its presumed beneficial effect, the administration of high dose steroid into patients with bacterial meningitis reduced the efficacy of vancomycin that is the initial empirical antibiotics. Therefore, physicians need to be more cautious with maintaining steroid therapy and its dosage.