r"clMI11-40 I--------

Dear Academy Fellow:In order to fulfill the admission requirements of AAP Bylaws, you are requested to:

Carefully review the following list of new applicants for Academy membership; and relay yourreactions directly to your District Chairperson, whose name and address is at the end of this list.

In submifting these names of board-certified pediatricians to you, it is understood that academicand pediatric credentials are not in question. Comments are requested concerning possible legaland/or ethical situations of which you might have personal knowledge.Send any comments on the following list of new applicants to your Distrid Chairperson by May 15.

: Dong Hee Park,: 314 Goideneye I

: Havre de Grace,

9 Pennsylvania

: Varalakshmi Suk: 151 S. Bishop Ai: Selane, PA 1901

: Shelley Williams: 186 State Rd.: Valencia, PA 16(

M.D.Ct., #314MD 21078

MichiganMatthew Waii3100 E. Eisen.Ann Arbor, M

Ohio

Neurological!FellowJohn Myseros3333 Burnet iCincinnati, 01

Illinois

Perniya Maso,10034 N. La (Skokie, IL 60C

Minnesota

Congenital HiSpecialty Fe/bnin+kan Llorm

Connedicut

Surgery Specialty FellowCynthia Gingalewski, M.D.Dept. of Surgery282 Washington St., Rm. 2GHartford, CT 06106

Lori Storch Smith, M.D.17 Waimsley Rd.Daden, CT 06820

Maria Uceda, M.D.29 Benedict Ct.Norwalk, CT 06850

Rhode Island

Bods Skurkovich, M.D.375 Allens Ave.Providence, RI 02905

9116129

f, M.D.BlvdCA 90056

hadi, M.D.53623

1119:11-11VII

Jocelyn Leung, A6566 Colbert St.New Odeans, LA

Texas

Louis Bezold, M.2527 Princeton IPeariand, TX 77!

Anika Chowhan,2222 MoronealHouston, TX 77(

Leslie Hollis, M.[105 SenderoDecatur, TX 762

Arizona

Amy Hyde, M.C2297 E. Saratog,Gilbert, AZ 852S

Colorado

AnesthesiologyJennifer Krupp,251 S. MonacoDenver, CO 802

Montana

Janis Irene Lang2312 Pine St.Billings, MT 591

New Mexico

Denise Colemar101 7 Bryn Ma%AAlbuquerque, N

Uniformed Se

M.D.

A 70124

: Califomia 2

: Denise Albury,: 5942 LaTijera0 Los Angeles, C

: Afagh Khorasl0: RO. Box 1615: Irvine, CA 926

: Florida

Jer, M.D.hower, Ste. 1001148108

Surgery Specialty

s, M.D.Ave.fl 45229

DISTRICT V

Stanford A. Sing36700 WoodwaSuite 300Bloomfield Hills,e-mail: ssinger.

DISTRICT VI

Kathryn Piziali N1314 Mordson!Madison, WI 5'e-mail: knichol.

DISTRICT VII

LD.Dr.'584

i, M.D.St. #422'030

D.

?34

0,yer, M.D.ird Ave.

MI 48304Oaap.orgkhavasi, M.D.

me., Apt. D-2518

s, M.D.

059

94 114-liel 0

4ichol, M.D.St.3703.aap.org

New York 1

Kathleen Brady, M.D.9 Alden Ct.Delmar, NY 12054

Patricia Monroe, M.D.Box 41OD Lake Colby Dr.Saranac Lake, NY 12983

New York 3

Karen Greer, M.D.175 E. 96th St., Apt. 8FNew York, NY'l 01 28

Delaware

Siobhan Irwin, M.D.41 York Rd.Wilmington, DE 19803

MajylandLara Akinbami, M.D.10201 Parkwood Dr.

Kensington, MD 20895

Dawn Bertram-Stewart, M.D.11383 Sifting Bull Cir.Lusby, MD 20657

Therese Cvetkovich, M.D.3636 N. Monroe St.Adington, VA 22207

Donald Egbuonu, M.D.3206 Chevedy Hills Ct.Cheverly, MD 20785

Befti Hertzberg,1800 Sunset HaMiami Beach, Fl

Elias Milgram, A7000 Island Blv(Aventura, FL 33

Lee Sanders, M.1447 Capri Ln.,Weston, FL 333

F. M. Antonieta11 279 NW 51 slMiami, FL 3317

DISTRICT I

0

: West Virginia: Patdcia Lutz, M.D.: 18 Woodhaven Dr.: Huntington, WV 25701

U111130

e

: Kentucky:

lg:tdl:lok

.,M.D.arbour Dr. #1 81 0I 33139

M.D.rd., Apt. 6013160

I.D.Apt. 6112326

i Schettino, M.D.;t Ter.78

: L. Leighton Hill, M.D.: Office of Admissions: Baylor College of Medicine: One Baylor Plaza, Rm. N104:

Houston, TX 77030: e-mail: Ihill.aap.org

: DISTRICT Vill0

0

0

)od, M.D.Crosse Ave.077

1191.140

3.

,ya St.96Richard Hall, M.D.

133 Strafton Plc.Mt Sterling, KY 40353

North Carolina

Khanh Eagle, M.D.16715-P Redcliff Dr.Huntersville, NC 28078

Jeffrey Kessel, M.D.1 1 20 8th St. Ln. NWHickory, NC 28601

South Carolina

Anna Leavift, M.D.800 North A St.Easley, SC 29640

Mojibola Solaja, M.D.106 Nautique Cir.Columbia, SC 29229

Ellen Turbeville, M.D.4657 Willow St.Loris, SC 29569

Virginia

Arlene Harrington, M.D.8112 Hampton Arbor Cir.Chesterfield, VA 23832

DI 612 9 N tdk1141-Ift

Indiana

Kirsten Turchan, M.D.12223 Pebblepointe PassCarmel, IN 46033

lead/own ev+,

t Surgery

ton, M.D.:. SE MMC 4954 55416

Jon R. Almquist, M.D.Virginia Mason Medical CenterDepartment of Pediatrics33501 First Way SouthFederal Way, WA 98003e-mail: jalmquist.aap.org

DISTRICT IX

Burton F. Willis, M.D.11 160 Warner Ave.Suite 101Fountain Valley, CA 92708e-mail: bwillis.aap.org

DISTRICT X

Charles Linder, M.D.Medical College of Georgia1120 15th St.Rm HF1 1 17

Augusta, GA 30912e-mail: clinder.aap.org

AmericanAcademy ofPediatrics

k-yninia riernngE(420 Delaware St.Minneapolis, MN

Missouri

Rafaela Herrera,12432 WestgateOverland Park, K

Saskatchewan

Abdulhafid Essali208-3806 AlbertRegina, SK S4S 3Canada

Esias Van Rensbu203-425 Third ASaskatoon, SK S.Canada

Wisconsin

Majdi Abu-Salih,216 E. Prospect!

%All C-71t

,Specialty FellowM.D..Pkwy.224

M.D.St.

<S 66213

0

0

Eileen M. Ouellette, M.D., J.D.Pediat(ic NeurologyNorth Shore Children's Hospital57 Highland Ave.Salem, MA 01 970e-mail: eouellette.aap.org

DISTRICT 11

Robert M. Corwin, M.D.Medical Director MedBest251 Salina Meadows Pkwy.Suite 100Syracuse, NY 13212e-mail: rcorwin.aap.org

DISTRICT III

Alan E. Kohrt, M.D.Medical Director/Children's Health NetChildren's Hospital ofPhiladelphia34th and Civic Center Blvd.Philadelphia, PA 19104e-mail: akohrt.aap.org

0,D,Ohr, M.D.

101

lah, M.D.t St.3R2

urg, M.D.kve. N7K5C4

Karl Yen, M.D.13443 Driver S,Anacortes, WA

WashingtonAidan De Renn971 1 1 th Ave.Longview, WA

John Dunn, M.1505 Queen AApt. 3ESeattle, WA 98

Califomia 1

Dena Lenser, AP.O. Box 5785,Modesto, CA c

St.k 98221

ne, M.D.

98632

i.D.knne Ave. N

Bi 09

,nj M.D.ivr Dr. NE4M 87106

.arvices-West

fl 53i

i, M.D.St.027: Harttord, WI

0

: Arkansas

: Eduardo Oci0

: 312 Brookpz: Liftle Rock, )

: Louisiana

: Joselyn Lee,: 1750 St. Chi: New Odean

0

: DISTRICT IV

: E. Stephen Edw: 2800 Blue Ridgi: Suite 501: Raleigh, NC 271: e-mail: sewards

0

:hoa, M.D.,arkAR 72205

vards, M.D.r,e Blvd.

F607

s.aap.org

M.D.iarles Ave., Apt. 505is, LA 70130 M.D.

0495357

'192 AAP News April 2001

WiL@91tt ~ -'0 'iI=9i:'le~~~'ID )-:,I:D~-

CLASSIFIEDADVERTISING PO I CYWhen you need to contact pediatri- News or the American Academy ofcians, contactAAPNews. Each rnonth Pediatrics of the product or servicemore than 55,000 pediatricians, pedi- advertised or ofthe claims made for theatric specialists, third-year pediatric product or service by the advertiser.residents and othersubscribers turn toAAP Newsforchildhealthinformation Classification: Classified ads arethey cannotget elsewhere. With a clas- accepted under Business Services,sified ad,you can speakdirectly to those General Announcements, Medicalreaders. Meetings, PhysiciansWanted, Positions

Wanted, Practices Available, Publica-Although the Academy believes these tions, Real Estate and Residencies/classified ads are from reputable FellowshipsAvailable.sources, theAcademy does not investi-gate the offers made and assumes no Display Classified Ads: Camera-ready,responsibility concerning them. 4-color, 3-color and 2-color display

classified ads are accepted underOccasionally, it is necessary to modify General Announcements, Medicalthe wording of classified ads. These Meetings, PhysiciansWanted, Positionschanges are generally made in compli- Wanted, Practices Available andance with the regulations ofvarious fed- Residencies / Fellowship s Available.eral and/or state commissions against Contact Roland Keve, The Walchlidiscrimination or because they might Tauber Group for display classified adbe interpreted as being unlawful or in sizes and rates.conflict with accepted professionalstandards of medical practice. Formore information, contact: Roland

Keve, The Walchli Tauber Group, (410)These advertising modifications are 420-031 1, or fax (410) 420-0711. Admade to maintain a classified section copyistobesentto: TheWalchliTauberthat is professionally responsible, law- Group, 112 W. Pennsylvania Ave., Ste.ful, scientific and free ofdiscrimination- 201, BelAir, MD 21014. Payments are to

Publcatono anadvrtismen in be mailed and made payable to ThePublcatono anadvrtlsmen mAP AmericanAcademy ofPediatrics, Dept.News neither constitutes nor implies a 7759 .Ciao,I 07-14guarantee or endorsement by AAP 7-59,CcaoIL67814

AAP NEWS Published MonthlyAmnericanAcademy of Pediatrics (* i

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PEDIATRIC INFECTIOUS DISEASE - TheDepartment of Pediatrics at the Universityof Florida Health Science Center-Jacksonville is announcing the availability ofa full-time faculty position in the PediatricInfectious Diseases Division. The appoint-ment will be at the tenure accruing level ofAssistant or Associate Professor or at thenon-tenure accruing level of ClinicalAssistant Professor or Clinical AssociateProfessor. The Pediatric Infectious Diseaseprogram has an accredited fellowship pro-gram and a successful clinical research pro-gram (both in infectious diseases and HIV)and is a NICHD sub-unit of PACTG. The

successful candidate will be responsible forproviding clinical service, in both inpatientand outpatient settings, education formedical students, house staff and pediatricinfectious diseases fellows and participationin clinical research. Opportunities for fun-damental research are also available. TheFirst Coast region of North Florida is a fastgrowing region with many -cultural andprofessional sports activities. Recruitingdeadline is May 1, 2001, with an antici-pated start date of May 24, 2001. Salaryis negotiable. Forward letter of intent,curriculum vitae, and the names andadd resses of th ree references to: MobeenRathore, M.D., Search CommitteeChairman, Department of Pediatrics,Division of Infectious Diseases, Universityof Florida-Jacksonville, 653-1 WestEighth St., Jacksonville, FL 32209, tele-phone: (904) 549-305 1, f a x :(904) 549-5341 or e-mail to:Mobeen.RathoreX?jax.ufl.edu. TheUniversity of Florida is an AffirmativeAction/Equal Opportunity Employer.

Midwest

Pediatric Pulmonologist

INDIANAPOLIS-Brand new Children'sHospital - St. Vincent Hospital and HealthServices is seeking an additional BE/13Cpediatric pulmonologist. We offer a pedi-atric sleep program, Level III NICU, PICU,a full scope of pediatric subspecialties, andin addition to the new hospital, an acutecare specialty hospital for children with spe-cial needs. We our committed to our chil-dren and we are seeking someone withsimilar passion. For more information, con-tact Sandra Whisman (317) 338'-6830, fax(317) 338-5002, sswhismaWstvincent.org.

Indianapolis - St. Vincent Children'sHospital, a part of St. Vincent Hospital andHealth Services-Indianapolis, is seeking afifth Pediatric Critical Care physician. St.Vincent is a 790-bed hospital on the grow-ing north side of Indianapolis. The Children'sprogram includes a 24-bed Pediatric Unit, a10-bed PICU, and a 39-bed NICU servingthe state's busiest delivery service. A new 40to 50-bed inpatient unit and a 12 to 14 bedPICU are in development. Many pediatricsubspecialty services are available, includingPulmonology, Hematology-Oncology,Cardiology, Gastroenterology, PediatricSurgery, Pediatric Neurosurgery, andPediatric ENT. St. Vincent is initiating aPediatric Cardiovascular Surgery service. Thephysician will join three fellowship-trainedand board certified critical care physicians.Responsibilities include care of patients in thePICU, outreach education, and administra-tive duties in the PICU. Clinical research isencouraged. Recent post-operative CV sur-gery experience and ECMO training arehighly desirable. Indianapolis is a comfort-able and convenient place to live whileenjoying the cultural and recreational ben-efits of a major city. Interested appli-cants should call: Sandra Whisman (317)33 8 -68 3 0, f ax (3 1 7) 3 3 8 -5002sswhismaX?stvincent.org.

PEDIATRIC EMERGENCY MEDICINE-Indianapolis, IN - Due to rapid growth in our

m

444

Aventis Pasteur currently has openings for experienced validation professionals at our campus in Swiftwater, Pennsylvania.

Individuals must be self-motivated and able to function effectively within a team-based organization. All positions require customer service oriented individuals, with an attention to detailand a commitment to quality. We are seeking individuals with a solid knowledge of pharmaceutical validation concepts and an understanding of Quality Systems for pharmaceutical manu-facturing. Individuals should also possess knowledge of processes, equipment, facilities, and systems utilized for the production of biological manufacturing.

The following positions are available:

Validation SpeciatlistProvides support for the completion of valIidation activities within one or more manufacturing areas. Prepares, executes, and reviews valIidation documentation, including protocols and reports.Participates on teams towards the completion of capital projects involving new systems and processes. Reviews and assesses changes to systems to ensure the continued state of control overlicensed manufacturing processes.

Junior to senior level positions available. Requires at least 3 years of experience with the qualification or validation of systems (biological experience preferred). Requires a B.S. in engineer-ing or equivalent experience.

Validation Project ManarParticipates in multidisciplinary product and process teams for the ongoing efforts to improve product quality and e iency. Prepares plans and schedules associated with the completionof capital projects involving new systems and processes. Reviews and approves documents associated with qualification and validation activities.

Must have a significant amount of experience with the management of projects for the qualification and validation of systems and processes (biological experience preferred). Requires atleast 10 years of experience with the qualification or validation of pharmaceutical equipment, facilities, systems, or processes.

Va/i"dation ScientistSenior position to assist with the development and approval of process or methods validation documentation. Interacts with multi-disciplinary teams to plan the validation of new biologi-cal manufacturing processes. Must have extensive process development or methods development background within a biological manufacturing environment.

Requires a Ph.D. or equivalent experience in area of expertise as well as extensive knowledge of validation requirements for biological process or methods validation.

Validation Engi'neerSenior position to assist with the specification and approval of new manufacturing equipment, facilities, and systems. Interacts with project teams to provide input on the design and imple-mentation of projects. Assists with the preparation of appropriate studies to challenge equipment, facilities, and systems.

Must have at least 10 years of experience with the design of systems for biological manufacturing, including experience with the qualification of those systems. This position requires a B.S.in an appropriate engineering discipline.

Aventis Pasteur offers an excellent salary and benefits package, ongoing opportunities for continuing education and professional development, and satisfaction of working for a leading edgecompany with an exceptional record of success in the global marketplace.

To learn more about Aventis Pasteur, visit the Aventis web site:

www.aventis.comPlease send your resume to: Human Resources, Aventis Pasteur, Discovery Drive, Swiftwater, PA 18370. E-mail: resumestaventis.com. Fax 570-839-0561.

We are an equal opportunity employer, M/F/D/V committed to a smoke-free and drug-free environment.

1194 AAP News April 2001

;r 0

Aventi's Pasteur

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References: 1. Greenberg RN. Overview of patient compliance with medication dosing: a literature review.Clin Ther. 1984;6:592-599. L PriceAlertlm. San Bruno, Calif: First DataBank; June 15, 2000;12:10,12,15,77.

ZITHROMAX"lazithromycin for oral suspension)

BRIEF SUMMARY

INDICATIONS AND USAGEZITHROMAXI (azithromycin) is indicated for the treatment of patients with mild to moderate infections (pneumonia:see WARNINGS) caused by susceptible strains of the designated microorganisms in the specific conditions listedbelow. As recommended dosages, durations of therapy. and agplicable gatient populations vary among theseinfections, please see DOSAGE AND ADMINISTRATION for specific dosina recommendations.

Acute otitis media caused by Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae. (Forspecific dosage recommendation, see DOSAGE AND ADMINISTRATION.)

Community-acquired pneumonia due to Chlamydia pneumoniae, Haemophilus influenzae, Mycoplasmapneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy. (For specific dosagerecommendation, see DOSAGE AND AOMINISTRATION.}

NOTE: Azithromycin should not be used in pediatric patients with pneumonia who are judged to beinappropriate for oral therapy because of moderate to severe illness or risk factors such as anyof the following: patients with cystic fibrosis, patients with nosocomially acquiredinfections, patients with known or suspected bacteremia, patients requiring hospitalization, orpatients with significant underlying health problems that may compromise their ability torespond to their illness (including immunodeficiency or functional asplenia).

Pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to first-line therapy in individualswho cannot use first-line therapy. (For specific dosage recommendations, see DOSAGE AND ADMINISTRATION.)

NOTE: Penicillin by the intramuscular route is the usual drug of choice in the treatment of Streptococcuspyogenes infection and the prophylaxis of rheumatic fever. ZITHROMAXI is often effective in the eradication ofsusceptible strains of Streptococcus pyogenes from the nasopharynx. Because some strains are resistant toZITHROMAXI, susceptibility tests should be performed when patients are treated with ZITHROMAX". Dataestablishing efficacy of azithromycin in subsequent prevention of rheumatic fever are not available.

Appropriate culture and susceptibility tests should be performed before treatment to determine the causativeorganism and its susceptibility to azithromycin. Therapy with ZITHROMAXI may be initiated before results of thesetests are known; once the results become available, antimicrobial therapy should be adjusted accordingly.

CONTRAINDICATIONSZITHROMAXt is contraindicated in patients with known hypersensitivity to azithromycin, erythromycin, or anymacrolide antibiotic.

WARNINGSSerious allergic reactions, including angioedema, anaphylaxis, and dermatologic reactions including Stevens JohnsonSyndrome and toxic epidermal necrolysis have been reported rarely in patients on azithromycin therapy. Althoughrare, fatalities have been reported. (See CONTRAINDICATIONS.} Despite initially successfulsymptomatic treatment of the allergic symptoms, when symptomatic therapy was discontinued, the allergicsymptoms recurred soon thereafter in some patients without further azithromycin exposure. These patientsrequired prolonged periods of observation and symptomatic treatment. The relationship of these episodes to the longtissue half-life of azithromycin and subsequent prolonged exposure to antigen is unknown at present.

If an allergic reaction occurs, the drug should be discontinued and appropriate therapy should be instituted.Physicians should be aware that reappearance of the allergic symptoms may occur when symptomatic therapyis discontinued.

In the treatment of pneumonia, azithromycin has only been shown to be safe and effective in the treat-ment of community-acquired pneumonia due to Chlamydia pnoumonise, Hsomophilus influenza@,Mycoplasmapneumoniao, or Stroptococcuspnoumoniao in patients appropriate for oral therapy.Azithromycin should not be used in patients with pneumonia who are judged to be inappropriate for oraltherapy because of moderate to severe illness or risk factors such as any of the following: patients withcystic fibrosis, patients with nosocomially acquired infections, patients with known or suspectedbacteremia, patients requiring hospitalization, elderly or debilitated patients, or patients with significantunderlying health problems that may compromise their ability to respond to their illness (includingimmunodeficiency or functional asplenia).

Pseudomembranous colitis has been reported with nearly all antibacterial agents and may range inseverity from mild to life-threateningl. Therefore, it is important to consider this diagnosis in patients whopresent with diarrhea subsequent to the administration of antibacterial agents.

Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowvth of clostridia.Studies indicate that a toxin produced by Clostridium difficile is a primary cause of 'antibiotic-associated colitis."

After the diagnosis of pseudomembranous colitis has been established, therapeutic measures should be initiated.Mild cases of pseudomembranous colitis usually respond to discontinuation of the drug alone. In moderate to severecases, consideration should be given to management with fluids and electrolytes, protein supplementation, and treat-ment with an antibacterial drug clinically effective against Clostridium difficile colitis.

PRECAUTIONSGeneral: Because azithromycin is principally eliminated via the liver, caution should be exercised when azithromycinis administered to patients with impaired hepatic function.

There are no data regarding azithromycin usage in patients with renal impairment; thus, caution should beexercised when prescribing azithromycin in these patients.

The following adverse events have not been reported in clinical trials with azithromycin, an azalide; however, theyhave been reported with macrolide products: ventricular arrhythmias, including ventricular tachycardia andtorsades de pointes, in individuals with prolonged QT intervals.

There has been a spontaneous report from the post-marketing experience of a patient with previous history ofarrhythmias who experienced torsades de pointes and subsequent myocardial infarction following a course ofazithromycin therapy.Information for Patients: Patients should be cautioned to take ZITHROMAXI suspension at least one hour prior to ameal or at least two hours after a meal. This medication should not be taken with food.

Patients should also be cautioned not to take aluminum- and magnesium-containing antacids and azithromycinsimultaneously.

The patient should be directed to discontinue azithromycin immediately and contact a physician if any signs of anallergic reaction occur.Drug Interactions: Aluminum- and magnesium-containing antacids reduce the peak serum levels (rate) but not theAUC (extent) of azithromycin absorption.

Administration of cimetidine 1800 mg) two hours prior to azithromycin had no effect on azithromycin absorption.Azithromycin did not affect the plasma levels or pharmacokinetics of theophylline administered as a single

intravenous dose. The effect of azithromycin on the plasma levels or pharmacokinetics of theophylline administered inmultiple doses resulting in therapeutic steady-state levels of theophylline is not known. However, concurrent use ofmacrolides and theophylline has been associated with increases in the serum concentrations of theophylline.Therefore, until further data are available, prudent medical practice dictates careful monitoring of plasmatheophylline levels in patients receiving azithromycin and theophylline concomitantly.

Azithromycin did not affect the prothrombin time response to a single dose of warfarin. However, prudent medicalpractice dictates careful monitoring of prothrombin time in all patients treated with azithromycin and warfarinconcomitantly. Concurrent use of macrolides and warfarin in clinical practice has been associated with increased anti-coagulant effects.

The following drug interactions have not been reported in clinical trials with azithromycin; however, no specificdrug interaction studies have been performed to evaluate potential drug-drug interaction. Nonetheless, they havebeen observed with macrolide products. Until further data are developed regarding drug interactions whenazithromycin and these drugs are used concomitantly, careful monitoring of patients is advised:

Digoxin-elevated digoxin levels.Ergotamine or dihydroergotamine-acute ergot toxicity characterized by severe peripheral vasospasmand dysesthesia.Triazolam-decrease the clearance of triazolam and thus may increase the pharmacologic effect of triazolam.Drugs metabolized by the cytochrome P450 system-elevations of serum carbamazepine, terfenadine, cyclosporine,hexobarbital, and phenytoin levels.

Laboratory Test Interactions: There are no reported laboratory test interactions.Carcinogenesis, Mutagenesis, Impairment of Fertility: Long-term studies in animals have not been performed toevaluate carcinogenic potential. Azithromycin has shown no mutagenic potential in standard laboratory tests: mouselymphoma assay, human lymphocyte clastogenic assay, and mouse bone marrow clastogenic assay.No evidence of impaired fertility due to azithromycin was found.Pregnancy: Teratogenic Effects. Pregnancy Category B: Reproduction studies have been performed in rats and miceat doses up to moderately maternally toxic dose levels (i.e., 200 mg/kg/day). These doses, based on a mg/m2 basis,are estimated to be 4 and 2 times, respectively, the human daily dose of 500 mg. In the animal studies, no evidence

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PEDIATRICS

American Academy 2of Pediatrics'

~~~~~~~~DEDICATED TO THE HEALTH OF ALL CHILDREN'

pediatric program, St. Vincent will be opening pitalized children. The successful candidate #0590, Denver Health Medical Center, 777Indiana's first pediatric emergency depart- will assume administrative responsibility Bannock St., Denver, CO 80204 (303) 436-ment this spring. We are looking to add two for inpatient and pediatric intensive care 6690.more pediatric emergency medicine trained units, will manage medical patients, andphysicians to our dynamic team. If you are will participate in medical student and res-interested, please contact Jill Winter (317) ident education programs. An appointment _3 38 -2 2 57; f ax ( 3 1 7 ) 3 3 8 -5002, to the faculty of the Department ofjcwinterWstvincent.org. Pediatrics, University of Colorado School of

Yucnato okfrtecide hMedicine is expected, and provides oppor- vstYouaauhraoff okeChilrten' childre who

INDIANAPOLIS, 1N- St. Vincent Hospital and tunities for research and clinical collabora- vstyu fie hlrnsBosbHealth Services is seeking an additional B/E or tion. Denver Health is an equal opportunity Pediatricians, a small run book publisher. GreatB/C neonatologist to join our group of 8 employer. Please direct inquiries to John marketing foryour practice. www.childrens-board-certified neonatologists.We havea39 W. Ogle, M.D., Director of Pediatrics, booksbypediatricians.com.bed Level III NICU. We are the largest deliv-ery system in the state with 4700 deliverieslast year. We are committed to our childrenand we are seeking someone with a similarpassion. For more information, call Jill Winter(317) 338-2510, fax (317) 338-5002, jcwin-ter?stvincent.org.I

THE 24th INTERNATIONAL CONFERENCEON PEDIATRIC/ADULT ALLERGY ANDCLINICAL IMMUNOLOGY, to be held at theFour Seasons Hotel, Toronto, Ontario,Canada, July 20-22, 2001. Sponsored by:SUNYAB 16 hours, Category 1, AMA andAAFP credit. Contact Michele: Phone (716)878-7105, Fax (716) 888-3841 or e-mail:mbauerQ?upa.chob.edu.

of harm to the fetus due to azithromycin was found. There are, however, no adequate and well-controlled studies inpregnant women. Because animal reproduction studies are not always predictive of human response, azithromycinshould be used during pregnancy only if clearly needed.Nursing Mothers: It is not known whether azithromycin is excreted in human milk. Because many drugs are excretedin human milk, caution should be exercised when azithromycin is administered to a nursing woman.Pediatric Use: (INDICATIONS AND USAGE.)

Acute Otitis Media (dosage regimen: 10 mg/kg on Day 1 followed by 5 mg/kg on Days 2-5): Safety andeffectiveness in the treatment of children with otitis media under 6 months of age have not been established.

Community-Acquired Pneumonia (dosage regimen: 10 mg/kg on Day 1 followed by 5 mg/kg on Days 2-5): Safetyand effectiveness in the treatment of children with community-acquired pneumonia under 6 months of age have notbeen established. Safety and effectiveness for pneumonia due to Chlamydia pneumoniaeand Myoplasma pneumoniaewere documented in pediatric clinical trials. Safety and effectiveness for pneumonia due to Haemophilus influenzaeand Streptococcus pneumoniae were not documented bacteriologically in the pediatric clinical trial due to difficulty inobtaining specimens. Use of azithromycin for these two microorganisms is supported, however, by evidence from ade-quate and well-controlled studies in adults.

Pharyngitis/Tonsillitis (dosage regimen: 12 mg/kg on Days 1-5): Safety and effectiveness in the treatment ofchildren with pharyngitis/tonsillitis under 2 years of age have not been established.

Studies evaluating the use of repeated courses of therapy have not been conducted.Geriatric Use: Pharmacokinetic parameters in older volunteers 165-85 years old) were similar to those in younger vol-unteers 118-40 years old) for the 5-day therapeutic regimen. Dosage adjustment does not appear to be necessary forolder patients with normal renal and hepatic function receiving treatment with this dosage regimen.

ADVERSE REACTIONSIn clinical trials, most of the reported side effects were mild to moderate in severity and were reversible upondiscontinuation of the drug. Approximately 0.7% of the patients (adults and children) from the multiple-dose clinicaltrials discontinued ZITHROMAXI (azithromycin) therapy because of treatment-related side effects. Most of the sideeffects leading to discontinuation were related to the gastrointestinal tract, e.g., nausea, vomiting, diarrhea, orabdominal pain. Potentially serious side effects of angioedema and cholestatic jaundice were reported rarely.Clinical: Adults: Multiple-dose regimen: Overall, the most common side effects in adult patients receiving amultiple-dose regimen of ZITHROMAX' were related to the gastrointestinal system with diarrhea/loose stools (5%),nausea 13%), and abdominal pain (3%) being the most frequently reported.

No other side effects occurred in patients on the multiple-dose regimen of ZITHROMAX'~with a frequency greaterthan 1%. Side effects that occurred with a frequency of 1% or less included the following:Cardiovascular. Palpitations, chest pain.Gastrointestinal: Dyspepsia, flatulence, vomiting, melena, and cholestatic jaundice.Genitourinary. Monilia, vaginitis, and nephritis.Nervous System: Dizziness, headache, vertigo, and somnolence.General: Fatigue.Allergic: Rash, photosensitivity, and angioedema.Single 1-gram dose regimen: Overall, the most common side effects in patients receiving a single-dose regimen of1 gram of ZITHROMAXI were related to the gastrointestinal system and were more frequently reported than inpatients receiving the multiple-dose regimen.

Side effects that occurred in patients on the single one-gram dosing regimen of ZITHROMAXI with a frequency of1% or greater included diarrhea/loose stools (7%), nausea (5%), abdominal pain 15%), vomiting (2%), dyspepsia (1 %),and vaginitis (11%).Single 2-gram dose regimen: Overall, the most common side effects in patients receiving a single 2-gram dose ofZITHROMAXI were related to the gastrointestinal system. Side effects that occurred in patients in this study with afrequency of 1% or greater included nausea (18%), diarrhea/loose stools (114%), vomiting (7%), abdominal pain (7%),vaginitis (2%), dyspepsia (1%), and dizziness (1%). The majority of these complaints were mild in nature.Children: Multiple-dose regimens. The types of side effects in children were comparable to those seen in adults,with different incidence rates for the two dosage regimens recommended in children.

Acute Otitis Media: For the recommended dosage regimen of 10 mg/kg on Day 1 followed by 5 mg/kg onDays 2-5, the most frequent side effects attributed to treatmenit were diarrhea/loose stools (2%), abdominal pain 12%),vomiting (1%), and nausea (11%).

Community-Acquired Pneumonia: For the recommended dosage regimen of 10 mg/kg on Day 1 followed by5 mg/kg on Days 2-5, the most frequent side effects attributed to treatment were diarrhea/loose stools (5.8%),abdominal pain, vomiting, and nausea (1.9% each), and rash (1.6%).

Pharyngitis/tonsillitis: For the recommended dosage regimen of 12 mg/kg on Days 1-5, the most frequent sideeffects attributed to treatment were diarrhea/loose stools (6%), vomiting (5%), abdominal pain (3%), nausea (2%),and headache 0 %).

With either treatment regimen, no other side effects occurred in children treated with ZITHROMAXI with afrequency greater than 1%. Side effects that occurred with a frequency of 1% or less included the following:Cardiovascular: Chest pain.Gastrointestinal: Dyspepsia, constipation, anorexia, flatulence, and gastritis.Nervous System: Headache (otitis media dosage), hyperkinesia, dizziness, agitation, nervousness, insomnia.General: Fever, fatigue, malaise.Allergic: Rash.Skin and Appendages: Pruritus, urticaria.Special Senses: Conjunctivitis.Post-Marketing Experience: Adverse events reported with azithromycin during the post-marketing period in adultand/or pediatric patients for which a causal relationship may not be established include:Allergic: Arthralgia, edema, urticaria, angioedema.Cardiovascular: Arrhythmias including ventricular tachycardia.Gastrointestinal: Anorexia, constipation, dyspepsia, flatulence, vomiting/diarrhea rarely resulting in dehydration,pseudomembranous colitis and rare reports of tongue discoloration.General: Asthenia, paresthesia and anaphylaxis (rarely fatal).Genitourinary: Interstitial nephritis and acute renal failure, moniliasis, vaginitis.Hematopoietic: Thrombocytopenia.Liver/Biliary: Abnormal liver function including hepatitis and cholestatic jaundice, as well as rare cases of hepaticnecrosis and hepatic failure, which have rarely resulted in death.Nervous System: Convulsions, dizziness/vertigo, headache, somnolence, hyperactivity, nervousness, and agitation.Psychiatric: Aggressive reaction and anxiety.Skin/Appendages: Pruritus, rarely serious skin reactions including erythema multiforme, Stevens JohnsonSyndrome, and toxic epidermal necrolysis.Special Senses: Hearing disturbances including hearing loss, deafness, and/or tinnitus, rare reports of tasteperversion.Laboratory Abnormalities: Adults: Significant abnormalities (irrespective of drug relationship) occurring during theclinical trials were reported as follows: with an incidence of 1-2%, elevated serum creatine phosphokinase, potas-sium, ALT (SGPT), GGT, and AST (SGOT), with an incidence of less than 1%, leukopenia, neutropenia, decreasedplatelet count, elevated serum alkaline phosphatase, bilirubin, BUN, creatinine, blood glucose, LDH,and phosphate.

When follow-up was provided, changes in laboratory tests appeared to be reversible.In multiple-dose clinical trials involving more than 3000 patients, 3 patients discontinued therapy because of treat-

ment-related liver enzyme abnormalities and 1 because of a renal function abnormality.Children: Significant abnormalities (irrespective of drug relationship) occurring during clinical trials were allreported at a frequency of less than 1%, but were similar in type to the adult pattern.

In multiple-dose clinical trials involving almost 3300 pediatric patients, no patients discontinued therapy becauseof treatment-related laboratory abnormalities.

DOSAGE AND ADMINISTRATION (See INDICATIONS AND USAGE.)Acute Otitis Media and Community-Acquired Pneumonia: The recommended dose of ZITHROMAXI for oral sus-pension for the treatment of children with acute otitis media and community-acquired pneumonia is 10 mg/kg as asingle dose on the first day (not to exceed 500 mg/day) followed by 5 mg/kg on days 2 through 5 (not to exceed 250mg/day).Pharyngitis/Tonsillitis: The recommended dose for children with pharyngitis/tonsillitis is 12 mg/kg once a day for 5days (not to exceed 500 mg/day).ZITHROMABX for oral suspension should be gliven at least I hour before or 2 hours after a meal.ZITHROMABX for oral suspension should not be taken with food.formore detailed professional informnation please refer to the full prescribing information.Revised July 2000

Pediatri;c Health

Southwest

DENVER, CO - Six Physician pediatric groupin south Denver seeking fulltime BC/BEpediatrician in a private practice setting.Competitive salary, benefits. Contact JulieDeckerman, M.D., 9094 E. Minoral Ave,Ste. # 120, Englewood, CO 80112, (303)779-5437.

The Department of Pediatrics at DenverHealth is seeking a faculty member toserve as the Director of Inpatient Services.Candidates should be BC in Pediatrics, andexperienced in the delivery of care to hos-

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April 2001 AAP News 195

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T Y P I C A L AT Y P I C A LStreptococcus pneumoniae Chlamydia pneumoniaeHaemophilus influenzae Mycoplasma pneumoniaeMoraxella catarrhalis

* BETTER COMPLIANCE MAY IMPROVE PATIENT OUTCOMES'* COSTS LESS THAN MOST BRAND-NAME ANTIBIOTICS'* PROVEN TOLERABILITY

In acute otitis media, the most common side effects are diarrhea/loose stools (2%), abdominal pain (2%),vomiting (1 %), and nausea (1 %). In community-acquired pneumonia, the most common side effects are diar-rhea/loose stools (5.8%), abdominal pain, vomiting, and nausea (1.9% each), and rash (1.6%).ZithromaxO (azithromycin for oral suspension) is contraindicated in patients with known hypersensitivityto azithromycin, erythromycin, or any macrolide antibiotic.

Zithromax is indicated for pediatric infections such as acute otitis media due to Hinfluenzae, Mcatarrhalis, or Spneumoniae, and community-acquired pneumonia due to Cpneumoniae, Hinfluenzae, Mpneumoniae, or Spneu-moniae.Oral azithromycin should not be used in pediatric patients with pneumonia who are judged to be inappropriate fororal therapy because of moderate to severe illness or risk factors such as any of the following: patients with cys-tic fibrosis, patients with nosocomially acquired intections, patients with known or suspected bacteremia, patientsrequiring hospitalization, or patients with significant underlying health problems that may compromise their abil-ity to respond to their illness (including immunodeficiency or functional asplenia).

Please see briefsummary ofprescribinginformation on adjacentpage.