xq- 33Vr,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 submitting 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 thie following list of new applicants to your District Chairperson by February 15.

Jeannine Stanwood, M. D., :445 Montrose Ave.:Elmhurst, IL 60126:

Sarah Sutton, M.D.629 S Wesley Ave.Oak Park, IL 60304

Gloria Valiente, M. D.4325 W. Roscoe St.Chicago, IL 60641

Iowa:

Congenital Heart SurgerySpecialty Fellow:Christopher Caldarone, M.D.:Div. of Cardiothoracic Sgy. :200 Hawkins Dr. 1616 JCPIowa City, IA 52242

Minnesota

Angelina Ausban, M.D. I715 MellwoodAve.IDuluth, MN 558041

Catherine Crosby-Schmidt, M.D.'10370 Stony CreekWoodbury, MN 55129

Barbara Gould, M.D.1023 Apel Ave.Worthington, MN 56187

Laura Kehrberg M.D.640 Westwood Dr. So'uthGolden Valley, MN 55416

Missouri

Saumitra Biswas, M.D.3660 S. Cox Ave., Apt. 2807Springfield, MO 65807

Jeanne Kornhardt, M.D.4633 Quail Run Rd.Farmington, MO 63640

Amy Poole-Yaeger, M.D.8720 Garden Ct.Brentwood, MO 63144

Joann Schumer, M.D.2704 Chapel Wood ViewColumbia, MO 65203

South Dakota

Michelle Baack, M.D.P.O. Box 1198Fort Pierre, SD 57532

Wisconsin

Otolrynolog Spcialty fellowJosehKrscher,M.D.900W.Wscnsi Av., MS 782A

Milwaukee, WI 53226

Otolaryngology Specialty FellowJames McMu rray, M. D.6113 S. Highalnds Ave.Madison, WI 53705

Karin Mulrooney, M. D.2300 Candlewyck Ct.Waukesha, WI 53188

Neurological SurgerySpecialty Fellow,Cheryl Muszynski, M.D._,Children's Hospital of WI Ped.,Neurosurgeryi9000 W. Wisconsin Ave.P.O. Box 1997, Milwaukee,All520

,MississippiRobert Cain, M. D.:102 Doctors Park:Starkville, MS 39759

VTexas

Rita Bair, M.D.2806 Sierra Salinas,San Antonio, TX 78259

Narinder Bhatia, M.D.:4609 Lemonwood Ln.Odessa, TX 79761

Enrique Cifuentes, M.D.7356 Parkridge Blvd., Apt. 398Irving, TX 75063

Mark Farrior, M.D.3506 Babbling CreekKingwood, TX 77345

Steven Leung, M.D.339 Touchdown Dr.Irving, TX 75063

Otolaryngology Specialty FellowJames Liu, M.D.31 Pleasure Cove Dr.N Houston, TX 77381

Naveed Mughal, M.D.11301 Fallbrook Dr., Ste. 324Houston, TX 77065

Otolaryngology Specialty FellowAlan Murray, M.D.Dept. of OtolaryngologyDallas, TX 75235

Paul Nowak, M.D.1515 N. OregonEl Paso, TX 79902

Karen Ostrom, M.D.907 DavidPalestine, TX 75801

Razaali Razak, M.D.3810 Shadow Knoll Ct.Houston, TX 77082

Faten Shabarek, M.D.311 TeakwoodHouston, TX 77024

Susan Tjeng, M.D.2104 Autumn Cove Dr.League City, TX 77573

Suzanne Whitbourne, M.D.7200 Almeda Rd., Apt. 307Houston, TX 77054

Alberta

Juzer Tyebkhan, M.D.175 Brander Dr.Edmonton, AB T6H5V4Canada

Arizona

Ariana Foster, M.D.5115 E. St. Andrew Dr.Tucson, AZ 85718

Ulhas Nadgir, M.D.1073 W. 23rd St.Yuma, AZ 85364

Marie Ruiz, M.D.4518 E. Palo Brea Ln.Cave Creek, AZ 85331

Colorado

Otolaryngology Specialty FellowGregory Allen, M.D.1056 E. 19th Ave., B455Denver, CO 80210

Hawaii

Cathy Bell, M.D.45206 Nohohani PI.Kaneoh-L-"ie,%Hl97AA

New Mexico

John Good, M.D.2839 Plaza Amarilla,Santa Fe, NM 87505

'Gillian Harris, M.D.'6321Avenida La Costa NEAlbuquerque, NM 87109

Michelle Webster, M. D.5518 Compadre Ct., NEAlbuquerque, NM 87111

Kyle Simmers, M.D.1590 Ruckel Dr.Niceville, FL 32578.Alain Sayad, M.D.

10 Giragis Zeidan St., 4th FlAchraeh BeirutLebanon

Yara Smit, M.D.c/o J. BergSPDC Warri/MDW-DRS ExpatMail/P.O. Box 245The Hague 2501 CEThe Netherlands

Connecticut

'Pamela Greenspon, M.D.4 Marsal Ln.Cromwell, CT 06416

Kenneth Platt, M.D.48 Silkey Rd.North Granby, CT 06060

Otolaryngology Specialty FellowRobert Weiss, M.D., FACS40 Cross St.Norwalk, CT 06851

Maine

John Hagerty, M.D.Div. of Neonatology Grand 7489 State St.Bangor, ME 04401

Massachussetts

Franz Babl, M .D., M. P.H .

10 Chamberlain Ave.Revere, MA 02151

Christine Barron, M.D.188 Clover Hill Rd.Whitinsville, MA 01588

Anesthesiology Specialty FellowPeter Foley, M.D.516 Carew St.Springfield, MA 01104

Deborah Francis, M.D.95 Lowell Dr.Stow, MA 01775

Maddie Hao, M.D.150 Quarry St., Apt. 415Quincy, MA 02169

Karen Heveron, M.D.75 Green Rd.Bolton, MA 01740

Alexandra lannini, M.D.81 School St.Acton, MA 01720

Patricia McQuilkin, M.D.51 Ann Lee Rd.Harvard, MA 01451

Anu Pathak, M.D.88 Break Neck Rd.Strubridge, MA 01566

Orthopaedics Specialty FellowPeter Waters, M.D.Dept. of Orthopaedic Surgery300 Longwood Ave.Boston, MA 02115

Elizabeth Weltman, M.D.

Medfield, MA 02052

Newfoundland

Padmavathy Guntamukkala, M.B.B.S.P.O. Box 1021St. Anthony, NF AOK 4S0Canada

Uniformed Services-East

Jeffrey Boris, M.D.900 Magnolia Bayou Blvd.Ocean Springs, MS 39564

Cynthia Polo, M.D.126 Walden Rd.New Bern, NC 28562

..

.

Monika Woods, M. D.416 Ritchie Pkwy.Rockville, MD 20852

New Jersey

Matthew Fisher, M.D.24 Oakdale Dr.

*Miliville, NJ 08332

Michael Geffner, M.D.:5 Davenport PI.:Morristown, NJ 07960

: Julie Isaacson, M.D.: 601 Seminole Dr., Apt. #8-E: Morganville, NJ 07751

*Zeenat Malik, M.D.8 Hansen Dr.Edison, NJ 08820

Maristela Nabong-Nillas, M.D.37 Rockingham Dr.

.Marlton, NJ 08053

:Florence Pandit, M.D.:19 N. Branch Dr.:Cherry Hill, NJ 08003

*Corazon Sanchez, M.D.2 Meyer Ct.

*Robbinsville, NJ 08691

PennsylvaniaPaul Bellino, M.D.1 15 Gearhart St.

:Riverside, PA 17868

:Anna-Marie Da Costa, M.D.:27 Woodside Farm Dr..Boothwyn, PA 19061

Judith Gardner, D.O.*1050 Houston Rd.*Yardley, PA 19067

*Otolarynpology Specialty Fellow*Ian Jacobs, M .D.Div. of Ped. Otolaryngology34th & Civic Ctr. Blvd.

:1 st Fl. Wood*Philadelphia, PA 19104

:Jenny Joslin, M.D.225 Avon Rd.Narbeth, PA 19072

Alanna Kramer, M.D.1726 Lombard St.

*Philadelphia, PA 19146

0Orhpaedics Specialty FellowStephen Mendelson, M.D.:3705 Fifth Ave.*Pittsb-urgh, PA 1 521 3

:Umai Shaik, M.D.:333 Vista Dr.Phoenixville, PA 19460

Kentucky

Joseph Pappalardo, M.D.:1 1 01 Springside Ct.*Louisville, KY 40223

:North Carolina

: David Becker, M.D.* 1 39-A. Purefoy Rd.* Chapel Hill, NC 27514

Mary Cox, M.D.80 Deer Glade Ln.

*Waynesville, NC 28786

Ester Graciano, M.D.:703 Bolin Creek Dr.:Carrboro, NC 27510

:Teresa Herbert, M. D.:#4 Brook For-est Dr..Arden, NC 28704

Tharon Howard, M.D.11140 Kerrimur Dr.

*Laurinburg, NC 28352

Tennessee

Gregory Plemmons, M.D. :Div. of Gen. Peds.5028 Medical Center EastNashville, TN 37232

Indiana

Tamara Blahunka, M.D.8937 Southpointe Dr., Ste. C-2Indianapolis, IN 46227

Anna Wildermuth, M.D.710 Wyandotte Ave.Lafayette, IN 47905

MichiganHabib Akrawi, M.D.6065 W. Knoll Dr., Apt. 422Grand Blanc, MI 48439

Marc Berg, M.D.574 Greenwood Ave., SEGrand Rapids, MI 49506

Emad Hammoude, M.D.3540 River Oaks Blvd., #3302Rochester Hills, Ml 48309

Otolaryngology Specialty FellowMarci Lesperance, M.D.Otolaryngology-Head & Neck Sgy.1500 E. Medical Ctr. Dr., F6905 MottAnn Arbor, MI 48109

Steven Pipe, M.D.8261 Lake Crest Dr.Ypsilanti, MI 48197

Susan Woolford, M.D.201 W Fulton St., Apt. 808Grand Rapids, Ml 49503

Ohio

Teresa Augustine, M.D.1012 E. Perkins Ave.Sandusky, OH 44870

Vaijanath Bhairappa, M.D.730 Quaker Court SWNew Philadelphia, OH 44663

Elizabeth Danish, M.D.17150 Creighton Dr.Chagrin Falls, OH 44023

Stacey Gibson-Hull, M.D.928 Sycamore Woods Dr.Tipp Ciy, OH 45371

Adiba Hamad, M.D.7255 Nightingale Dr., #2Holland, OH 43528

Otolaryngology Specialty FellowSally Shott, M.D.7193 Fair O>aks Dr.Cincinnati, OH 44237

Ontario

Franciscus Dicke, MD.46 Havenwood WayLondon, ON N6H 51B8Canada

Illinois

Marc Connery, M.D.340 Virginia Ave.Glenwood, I L 60425

:Anesthiesiology Specialty Fellow:Pankaj Haridas, M.D.:222 Woodlet Ln.Bollingbrook, IL 60490

:Terrie Murdaugh, M. D.:3263 Patterson Pi. Dr., #205*Saint Louis, MO 63129

Poornima Narayen, M.D.330 DtupahzeNaperville, L 60565

New York 1

Navaz Dolasa, M.D.:10 Erwin Ave., Apt. Left.Massena, NY 13662a

I: Luis Ghiglino, M.D.:: 306 Brady Rd.:: Sackets Harbor, NY 13685 :

*Marie Kessler, M.D.19 Sussex Ln.

.Lancaster, NY 14086e

Christina McHugh, M.D. .

38 Second St.*Saratoga Springs, NY 1 2866

:NewYork 2:

:Soungwon Bae, D.O. ::54 Misty Rd.::Rocky Point, NY 11778 :

Ajey Jain, M.D.e14 1-U Willets Rd. W. North HillsRoslyn, NY 1 1576e

Otolaryngology Specialty FellowSaul Modlin, M.D.975 Franklin Ave..Garden City, NY 11530

:Otolaryngology Specialty Fellow:William Spencer, M.D.:13 E. Carver St.Huntington, NY 1 1743

*New York 3

Bertha John, M.D.230 E. 71st St., Apt. 4J*New York, NY 10021

Kevin McDonough, M.D.:316 Neal DowAve.:Staten Island, NY 10314

:Anna Nowak-Wegrzyn, M.D.169 India St.Brooklyn, NY 11222

Sumati Pande, M.D.100 Grand Cove Way, #1 P*Edgewater, NJ 07020

Laura Robbins-Milne, M.D.645 West End Ave., #913*New York, NY 10025

*Delaware

*Fizul Bacchus, D.O.*31 S. Prestwick Ct.*Dover, DE 19904

Varuna Tuli, M.D.725 North Shore Dr.*Milford, DE 19963

:District of Columbia

:Jayashree Rasehu, M.D., M.B., B.S.Div. of Neonatology3800 Reservoir Rd., Ste. #M3400*Washington, DC 20007

*MarylandGad Alpan, M.D.

,.4322 Bedrock Cir., Apt. 203Baltimore, MD 21236

*rEliz7abet Fronc, AA.D.:269 Peninsula Farrm Rd., Ste. F:Arnold, MD 21012

Mary Mailander, M.D..3447 Arcadia Ave.Ellicott City, MD 21 042

Ann Schwartz, M.D.718'Beacon Hill Ter.*Gaithersburg, MD 20878

46 AAP News January 2001

-14- - Fy- - /-:,-\. ( =./T. 1 .!-j.-k I I :. \ AD/ ID LIriP... _g-..Jjjljlljjjl nowdowbMA"M

_,q

Iqliblb

Xavier Sevilla, M.D.12735 Nightshade PI.Bradenton, FL 34202

:Otolaryngology Specialty Fellow:Ira Stein, M.D.:5325 Greenwood Ave., Ste. 202:West Palm Beach, FL 33407

.Georgia

*Sook Ahn, M. D.*220 Terrane Ridge*Peachtree City, GA 30269

Marsha Blume, M.D.:6221 Madison Dr.:Atlanta, GA 30346

:Donna-Marie Brown, M.D.:307 N. Decatur Ln.*Decatur, GA 30033

.Mark Papania, M.D.*3649 Wentworth Ln.Lilburn, GA 30047

Adriana Rzeznik, M.D.393 Morris Dr.Americus, GA 31709

: Carlos Soriano, M.D.: 97 Atlantic St., Ste. 101: McDonough, GA 30253

DISTRICT I

Eileen M. Ouellette, M.D., J.D.Pediatric NeurologNorth Shore Childryen's Hospital

:57 Highland Ave.:Salem, MA 01970*e-mail: eouelletteWaap.org

DISTRICT II

Robert M. Corwin, M.D.Medical Director - MedBest251 Salina Meadows Pkwy.Suite 100Syracuse, NY 13212e-mail: rcorwinEaap.orgDISTRICT III

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

E. Stephen Edwards, M.D.2800 Blue Ridge Blvd.Suite 501Raleigh, NC 27607e-mail: sewardsOaap.orgDISTRICT V

Stanford A. Singer, M.D.36700 Woodward Ave.Suite 300Bloomfield Hills, Ml 48304e-mail: ssingerEaap.org

DISTRICT VI

Kathryn Piziali Nichol, M.D.P.O. Box 339Boca Grande, FL 33921e-mail: knicholOaap.org

OregonPilar Bradshaw, M.D.1999 Moss St.Eugene, OR 97403

Warren Griffin, M.D.2478 13th St., SESalem, OR 97302

Marlo Mcllraith, M.D.5903 NE 10Oth Ave.Portland, OR 97211

Uniformed Services-West

Robert Miller, D.O.4 Thayer St.Ft. Leonard Wood, MO 65473

Utah

Daniel Satterwhite, M.D.2554 E. Skyline Dr.Salt Lake City, UT 84108

Washington

Evangeline Gan, M.D.P.O. Box 447llwaco, WA 98624

Catherine Shubkin, M.D.902 E. Caroline St.Port Angeles, WA 98363

California I

Laurie Liang, M.D.151 Calderon Ave., #182Mountain View, CA 94041

Janesta Noland, M.D.2816 Alhambra Dr.Belmont, CA 94002

Kara Ornstein, M.D.52 Laurel Ave.San Anselmo, CA 94960

Ophthalmolog;y Specialty FellowJames Ruben, M.D.1650 Response Rd.Sacramento, CA 95815

California 2

William Lin, M.D.3838 Sherman Dr., Ste. 203Riverside, CA 92503

Mayra Rosado, M.D.528 Coolidge Dr.San Gabriel, CA 91775

Tristy Shaw, M.D.1813 Oak Ave.Manhattan Beach, CA 90266

Mary Wakim, M.D.27762 Desert PI.Castaic, CA 91384

California 3

Tom Chu, M.D., Ph.D.5394 Camino Playa NorteSan Diego, CA 92124

Jana Mullen, M.D.2067 W. Vista Way, Ste. 180Vista, CA 92083

Gina Rosenfeld, M.D.139 S. Nardo Ave.Solana Beach, CA 92075

California 4

Jereme Butler, M.D.916 Esplanade, Apt. 204Redondo Beach, CA 90277

DISTRICT Vll

L. Leighton Hill, M.D.Office of AdmissionsBaylor College of MedicineOne Baylor Plaza, Rm. N 104Houston, TX 77030e-mail: IhillOaap.orgDISTRICT Vlill

Jon R. Almquist, M.D.Virginia Mason Medical CenterDepartment of Pediatrics33501 First Way SouthFederal Way, WA 98003e-mail: jalmquistEaap.orgDISTRICT IX

Burton F. Willis, M.D.11160 Warner Ave.Suite 101Fountain Valley, CA 92708e-mail: bwillisWaap.orgDISTRICT X

Charles Linder, M.D.Medical College of Georgia1120 15th St.Rm. HF1117Augusta, GA 30912e-mail: clinder@?aap.org

AmericanAcademy ofPediatrics

Alabama

Vick Di Carlo, M.D.2010 Brookwood Med. Ctr. Dr.Ste. 102 WMCBirmingham, AL 35209

Florida

Alina DiLiddo, M.D.7753 Highlands Cir.Margate, FL 33063

Christopher Emanuel, M.D.3945 San Jose Park Dr.Jacksonville, FL 32217

Luis Maramara, M.D.P.O. Box 2007Palm Harbor, FL 34682

Nelly Marcano, M.D.6108 Chene Ct.Lutz, FL 33549

Abby Pudpud, D.O.31C Venetian Way, Apt. #45Miami Beach, FL 33139

Jose Rosa, M.D.15148 SW 127th Ct.Miami, FL 33186

Maria Rosa, M.D.8291 SW 87th Ter.Miami, FL 33143

Luis Seguias, M.D.6422 Collins Ave., Apt. 901Miami Beach, FL 33141

Jennifer Seidenberg, M.D.424 Mara Dr.Crestview, FL 32536

44After ten years of agonizing, diapers,and two ineffective drugs, our sonfinally has the confidence for a sleep-over, thanks to the Potty Pager.

Daniel E. Turnbull

It's wireless. It's private. It inspires letters like this.And now it's CLINICALLY PROVEN EFFECTIV-E.

In a two year clinical study at the University ofAlabama medical school, thePotty Pager has been proven 71% effective on hard-to-reach TEEN bedwet-ters. (Lo, Perez, Hanchrow and Joseph)

So whyjust "control" bedwetting with drugs when youcan CURE it! With the WIRELESS alarm that wakesthe BEDWETTER... not the whole house!

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For complete information call: 800-497-6573 or 303-440-8517

Or visit our web site: www.pottypager.comIDEAS FOR LIVING, INC. BOULDER, COLORADO 80304

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wetting problem!

January 2001 AAP News 47

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CLASSIFIED ADVERTISING POLICYWhenyou need to contact pediatricians, contactAAPNews. Each month more than 55,000 pediatricians, pediatricspeciaists,third-year pediatric residentsand othersubscribers turn toAAPNewsforchild health information theycannotgeteLsewhere.With a ckassified ad, you can speak directly to those readers.

Adolescent MedicineOpen Rank Professor of Pediatrics, ResearchThe Division of Adolescent Medicine at Children's Hospital Medical Center of Cincinnati seeks a Ph.D.Or M.D. for assistant, associate or full professor of pediatrics, research track. We encourage applicantsfrom a broad range of disciplines, including-but not limited to-sociology, psychology, anthropology,economics, nursing and medicine. Candidates must hold a doctoral degree and have a record of publica-tions and successful grant experience. We are particularly interested in candidates whose research focus-es on social inequalities in health. Responsibilities include functioning as an independent investigator,able to attract extramural grant support. Ample opportunities exist for multidisciplinary collaboration.Send CV, letter of interest and names of three references to:

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re you...

.concemned withADHD evaluativ,.o .

Although the Academy believes these classified ads are from reputablesources, theAcademy does not investigate the offers made and assumesno responsibility conceming them.

Occasionally, it is necessary to modify the wording of classified ads.These changes are generally made in compliance with the regulations ofvarious federal and/or state commissions against discrimination orbecause they might be interpreted as being unlawful or in conflict withaccepted professional standards of medical practice.These advertising modifications are made to maintain a classified sectionthat is professionally responsible, lawful, scientific and free of discrimi-nation.

Publication of an advertisement in AAP News neither constitutes norimplies a guarantee or endorsement by AAP Newfs or the AmericanAcademy of Pediatrics of the product or service advertised or of theclaims made for the product or service by the advertiser.

Classification: Classified ads are accepted under Business Services.General Announcements, Medical Meetings, Physicians Wanted,Positions Wanted. Practices Avaflable, Publica- tions, Real Estate andResidencies/ Fellowships Available.

Display ClassZfled Atds: Camera-ready, 4-color, 3-color and2-color display classified ads are accepted under GeneralAnnouncements, Medical Meetings, Physicians Wanted, PositionsWanted, Practices Available and Residencies/ Fellowfships Available.Contact Roland Keve, TheWaichli TauberGroup for display classified adsizes and rates.

Formore Infornatbon,contacteRoland Keve, TheWalchli Tauber Group,(410) 420-031 1, or fax (410) 420-071 1. Ad copy is to be sent to: TheWalchli Tauber Group, 112 W. Pennsylvania Ave., Ste. 201, Bel Air, MD21014. Payments are to be mailed and made payable to The AmericanAcademny of Pediatrics, Dept. 77-5194, Chicago, IL 60678-5194.

A"P NEWSPublished MonthlyAinerican Academy Of PediatricsP.O. Box 927Elk Grove Village, IL 60009-0927

48 AAP News January 2001

CS e ~~~~~~IA CME Meeting in Practical Pediatric Topics

and a Practice Management Seminar

GENERAL PEDIATRICOPPORTUNITIES

Outstand'ing Pediatric opportunities withProMedica Health System in SoutheastMichigan. ProMedica Health System wasrecently rated 29th most 'integrated networkby Modern Healthcare Magazine.Compet'it'ive compensation and benefitpackage offered. Please contact JanetFredrick at 800-427-2755 for additionalinformnation on practice opportunities.Fax: 419-479-6962E-mail: janet.fredrickgpromedica.orgSorry, no JI opportunities.

Memnber of

,*PROM~EDACA.HEALTH SYSTEIM

D 3~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~.

Rdefeences: 1. Greenberg RN. Overview of patient compliance with medication dosing: a literature review.Clin Ther. 1984;6:592-599. 2. fica4lertTm. San Bruno, Calif: first DataBank; June 15, 2000;1210,12,15,77:

ZITHROMAX)jazithfomycin fof ofal suspension)

BRIEF SUMMARY

INDICATIONS AND USAGEZITHROMAX" (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 apglicable patient populations valy among theseinfections, please see DOSAGE AND ADMINISTRATION for speific dosing recommendations,

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

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

NOTE Azithfomycin should not be used in pedidric padents with pneumonia who are judged to beinapproprieb for oral thwapy because of moderate to sewro illnas or risk factors such as anyof the following: p tients with cystic fibrosis, patients with nosocomially acquiredinfections, pationts with known or suspocted bacteremin, p tients requiring hospitalization, orpedents with siginificant underlying health problems that may compromnise their ability torespond to their illness (including immunodeficiency orfuhnctional asplania).

Pharyngitis/tonsillitis caused by Streptococuspyogenesas an altemative 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. ZITHROMAX( is often effective in the eradication ofsusceptible strains of Streptococcuspyogenesfrom the nasopharynx. Because some strains are resistant toZITHROMAX", susceptibility tests should be performed when patients are treated with ZITHROMAXI. Dataestablishing efficacy of azithromycin in subsequent prevention of rheumatic fever are not available.

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

CONTRAUNDICATIONSZITHROMAX( 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, wvhen symptomatic therapy was discontinued, the allergicsymptoms recurired soonthmraltreMn some patients withouthfrdh r azlthromycin 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 unknovvn at present.

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

In the treatment of pneumonia, azithiromycin has only been shown to be safe and effective in the tresat-menrt of community-acquim d pneumonia due to Chlamyispneumonimo, Hoomophilus influenzao,Mlycoplasms pneumonaiso, or _bptcoccuspnoumonioe in pedents appropriete for oral therapy.Azithromycin should not be used in patients with pneumonis who are judged to be inappropriaew for oraltherapy because of moderate to severe i111ness or risk factors such as any of the following: p tients wkhcystic fibrosis, patients wit nosocomially acquifed infoctons, patients with known or suspectedbacteremini, patients requiring hospitalization, ledery or debilitaed patients. or patief whh significantunderlying health problems that may compromise their ability to respond to their illness(includingi_mmde1icincy w functional asplenia).

P_mdonemnbranous colitis has been reported with nearly all antibacterial agents and may range insawl from mild to life-threatening. Therefore, it is imponant to consider this diagnosis in patients whopwith diarrhea subsequenttothe administration of antibacterial aglentLTfinent with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridia.

SbJid 11ndicate that a toxin produced by Clostridium difficile is a primary cause of 'antibiotic-associated colitis."Aftr 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 difficilecolitis.

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,oointes, in individualIs with prolonged AT intervals.

There has been a spontaneous report from the post-marketing experience of a patient with previous history ofarrhythmias who experienced torsades depointesand subsequent myocardial infarction following a course ofazithromycin therapy.Information for Patients: Patients should be cautioned to take ZITHROMAX" 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 (800 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.

Labor or 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 matemally toxic dose levels (i.e., 200 mg/kg/day). These doses, based on a mg/m2basis,are estimated to be 4 and 2 times, respectively, the human daily dose of 500 mg. In the animal studies, no evidence

CONFERENCES IN SAN DIEGO, sponsoredby Children's Hospital & Health Center, SanDiego, Califomia: Advances in the Practiceof Pediatrics, San Diego 2001, March 2-4,

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2001, Category 1 credit, 15 hours; PediatricDermatology for thie Practitioner, San Diego2001, April 20-21, 2001, Category 1 credit,12 hours; Current Concepts in PediatricRespiratory Diseases, San Diego 2001, June29-July 1, 2001, Category 1 credit, 16 hours.For more information contact: ContinuingMedical Education, Children's Hospital-SanDiego, phone (888) 892-9249, (858) 576-4072, Fax (858) 495-8587 or e-mailrwebbOchsd.org. Visit our Web site atcmeOchsd.org.

21st ANNUAL NATIONAL PEDIATRICINFECTIOUS DISEASE SEMINAR, April 18-21, 2001, Grand Hyatt Washington,Washington, DC. The Seminar is jointly spon-sored by the University of Texas South-western Medical Center at Dallas, TX, theaccrediting institution, and the NationalPediatric Infectious Diseases Foundation.CME/AAP credits offered. For further infor-mation or to register for the meeting, consultthe Web site: www.cwiweb.com/npids or call(214) 648-2166; Telefax: (214) 648-2317.

Southeast

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Midwest

PEDIATRIC OPPORTUNITY IN MICHIGAN:Unique pediatric practice opportunity avail-able in Mid-Michigan. Seeking full-timeBE/BC Pediatrician to join large primary carenetwork. Employed position with very com-petitive salary, full benefit package, reloca-tion expenses, CME and much more! Weregret these communities do not meet stan-dard for visa waivers. For more informationplease contact: Courtney Cole, PhysicianRecruitment, 401 S. Ballenger Hwy, Flint, Ml48532. (810) 342-1050 or fax CV to (810)342-1076. ColecEmclaren.org.

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BEAUTIFUL TAOS, NEW MEXICO! Wanttoutilize your training/skills for a diverse, grate-ful population? Consider this interestingpractice in a Rocky Mountain setting. Join 3.5pediatricians (all excellent credentials) pro-viding primary/specialty care to rural/smalltown population of 35,000 in two northernNew Mexico counties. As the only pediatri-cians, they see everything from well babiesto young adults with complex chronic dis-ease. They practice aggressive, evidence-based medicine with excellent case man-agement; patients referred for UNM orUniversity of Colorado-Denver consults aretreated in Taos. The physicians are supportedby two nurse practitioners, 3 RNs.Compensation package is competitive.Historic Taos, home to artists/writers, hastremendous culture, great restaurants,world-class recreation . Details: CaroleGregory?MedQuest; home (800) 220-6331; fax (505) 758-5325; e-mailmedquestOtaosnet.com.

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PACI FIC NORTHWEST - Spokane, WA:Seeking BE/BC Pediatrician to establishedthriving solo pediatric practice with 1 PA-Cand 1 ARNP. Inpatient/outpatient care.Located across from well-equipped, pro-gressive hospital. Guaranteed salary andbenefits package. Potential partnership.Spokane offers affordable housing in quiet

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 Mothem 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.Pedisric 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 Chlamydiapneumoniaeand Mycoplasmapneumroniaewere documented in pediatric clinical trials. Safety and effectiveness for pneumonia due to Haemophilus influenzaeand Streptococcuspneumoniaewere 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 evaluatingl the USe of repeated courses of therapyr have not been conducted.Geriatric Use: Pharmacokinetic parameters in older volunteers (65-85 years old) were similar to those in younger vol-unteers (1B-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 ZITHROMAX5 (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: Adulls: 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 DV%, 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:Cardiovasculbr Palpitations, chest pain.Gostrointstlinall: Dyspepsia, flatulence, vomiting, melena, and cholestatic jaundice.Genitourinary: Monilia, vaginitis, and nephritis.Nervous Systom: Dizziness, headache, vertigo, and somnolence.Genral: Fatigue.Allergic: Rash, photosensitivity, and angioedema.Single 1-gram dose regimeff Overall, the most common side effects in patients receiving a single-dose regimen of1 gram of ZITHROMAX" were related to the gastrointestinal system and were more frequently reported than inpatents receiving the multiple-dose regimen.

Side effects that occurred in patients on the single one-gram dosing regimen of ZITHROMAX" with a frequency of1% or greater included diarrhea/loose stools l7%). nausea 15%), abdominal pain (5%1. vomitin,q 12%), dyspepsia ll %),and vaginitis (11%).Single 2-gram dose regimen: Overall, the most common side effects in patients receiving a single 2-gram dose ofZITHROMAX" were related to the gastrointestinal system. Side effects that occurred in patients in this study with afrequency of 1% or greater included nausea ll18%). diarrhea/loose stools (14%), vomiting 17%). abdominal pain 17%).vaginitis l2%). dyspepsia (11%), and dizziness ll %). The majoritV 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 GnDays 2-5, the most frequent side effects attributed to treatment were diarrhea/loose stools l2%). abdominal pain (2%),vomiting (1 %). and nausea ll %).

Community-Acquired Pneumonia: For the recommended dosage re,qimen 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 l5.8%).abdominal pain, vomiting, and nausea ll.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 l6%). vomiting l5%). abdominal pain l3%). nausea l2%).and headache ll %).

With either treatment regimen, no other side effects occurred in children treated with ZITHROMAX(@ 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 Systemn: Headache lotitis media dosage), hyperkinesia, dizziness, agitation, nervousness, insomnia.General: Fever, fatigue, malaise.Allergic: Rash.Skin and Appendages: Pruritus, urticaria.Special Sensos: Conjunctivitis.Post-Marketing Experience: Adverse events reported with azithromycin during the post-marketing period in adultand/or pediatric patienfs for which a causal relationship may not be established include:Allerglic: 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.Hem topoietic:Thrombocytopenia.Uver/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.PsychiZric: Aggressive reaction and anxiety.Skin/Appendages: Pruritus, rarely serious skin reactions including erythema multiforme, Stevens JohnsonSyndrome, and toxic epidermal necrolysis.Special Sensor. Hearing disturbances including hearing loss, deafness, and/or tinnitus, rare reports of tasteperversion.Laboratory Abnormalities: Adulls 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 lSGPT). GGT. and AST lSGOT); 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 ADMINISUTIAON (See INDICATIONS AND USAGE.)Acute Ofitis Media and Community-Acquired Pneumonia: The recommended dose of ZITHROMAX" 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).Pharynitis/Tonsillitils The recommended dose for children with pharyngitis/tonsillitis is 12 mg/kg orice a day for 5days(not to exceed 500 mg/day).ZITHROMAX fororal suspension should be given at leas I houf before or 2 hours aftera meal.ZITHROMAXfor oral suspension should not be taken withfood.Formfore detailedprofessional information please refer to the full prescribifng inforrnation.Revised July 2000

4 Comoltte'd to iNGsG) 2000 Pfizer Inc. ZC225AOO

January 2001 AAP News 49

50nce-daily dose(efcc ht' ayfryorltl atet otk

COVERAGE OF KEY RESPIRATORY PATHOGENS

T Y P I C A L AAT 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 tollowing: patients with cys-tic tibrosis, patients with nosocomially acquired infections, patients with known or suspected bacteremia, patientsrequiring hospitalization, or patients with signiticant underlying health problems that may compromise their abil-ity to respond to their illness (including immunodeficiency or functional asplenia).

Please see brief summary ofprescribinginformation on adjacentpage.