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IAMERICAN ACADEMY OF PED4IATRCS

1997 AL\nnucd Meet'ingNovember I - 5 * New Orleans, LA

OAAP 755 (H706) SECTION ON SURGERYPediatric Oncology; Malignant Germ CellTumors; Malignant Sacrococcygeal Teratomas;Testicular Germ Cell Lesions; Ovarian GermCell Lesions

OAAP 756 (S101) Disorders that Mimic ADHD:Misdiagnosis of Attentional Problems

OAAP 7111 (S102) Pearls in Practical Ophthalmologyfor the Pediatric Practitioner

O3AAP 757 (S103) Common Genitourinary Problems:Evaluation and Managemnent

OAAP 761 DIALOGUE SESSION PM: AlternativeTherapy in Neurology: You Want to Do Whatto Your Child?Treatment of Headaches and Cerebral Palsy;Traditional Approach to Cerebral Palsy;Alternative Approach to Seizures

O3AAP 7112 (S119) Office Mangmn and HealthSupervision of Children with Common GeneticDisorders

OAAP 762 (S122) Management of CommonBacterial and Viral Infections

O3AAP 759 (H127) Section on Allergy and 1nuo-ogy: Hot Topics in Pediatric Allergy, Asthma,and Imnlogy...3 cassettes, $33

O3AAP 760 (J130) A Virus Called FireanmsO3AAP 766 DIALOGUE SESSION AM

New Developments in Breastfeeding Inants;Growthi Patterns and Breastfed Inants; nfants/Parent Bed Sharing; Insufficient MilkSyndrome

OAAP 767 (S204) Controversies and Updates inPediatric Emergency Medicine

O3AAP 768 (S206) Adolescent Addiction Seminar IO3AAP 769 (J209) Violence and Children: What Are

We Doing and Where Do We Stand?OAAP 764 (H211) Section on Allergy and

Imuoogyhnnteapy in Asthma; Nebulizer Use for

Asdua in Children Less Than 3 Years Old..9.3 cassettes, S33

OAAP 76S (H213) Section on Administration andPractice Management and the ResidentSection-Entering Practice: The Early Years..3 cassettes, $33

OMAP 763 (E1232) Section on OrthopaedicsKeynote Address: "Early Surgical Repair ofBrachial Plexcus Birth Injuries" (John P.Laurent, M.D., FAAP)...3 cassettes, $33

O3AAP 770 DIALOGUE SESSION PM: PediatricGastro-esophageal Reflux; Results ofTreatmnent

O3AAP 771 (S223) Antibiotics and AntiviralsOIAAP 7116 (S226) Common Pediatric ENT ProblemsO3AAP 7119 (S227) Abdominal Pain in the School-

Aged ChildO3AAP 77 PLENARY SESSION AM

President's Address (Robert E. Hannewmun,M.D., FAAP); Keynote Address (Captain GeneCernan); Resistant Pneumnoccocal Infections;Bacterial Toxcin Disease; Prevention ofPerinatal HIV; Future of Pediatric Education

O3AAP 774 (S304) Promoting Breastfeeding in thePediatric Office

O3AAP 77S (S338) Introduction to ImnlogyOAAP 776 (H317) Section on Infectious Diseases-

Emerging Infections in PediatricsEmerging Viral and Rickettsial Inections;E. coli 0157 Infections; Erlichiosis; InvasiveGroup A Strep Infections

OAAP 778 PLENARY SESSION PMChanges in the AAP Policy on Fetus &Newborn; Outcomes for Infants Who UndergoHeart Surgery; Literacy Promotion; Meet theRed Book Conunittee

O3AAP 779 (S325) Drug Profiling: How to DefendiYourself

O3AAP 7117 (S326) Withi Every Breath You Take:Environmental Healthi Problems

O3AAP 7114 (S327n Gait Problemn Look-alikesO3AAP 780 (S328) Practical Management of ADHD

in the OfficeOAAP 783 (F337) Group B Strep: Managemnent After

Maternal Prophylaxis...l1 cassette, $11O3AAP 782 (F339) Seven Herbs Every Pediatrician

Should Know...1 cassette, $11OAAP 7113 (H321) Section on Adolescent Health-

Practical Aspects of Adolescent CareHematuria, Proteinuria and Nephritis in theAdolescent; Psychopharmacology of AdolescentAttention and Mood Disorders; Coding andReimbursemnent of Adolescent Health Care...3 cassettes, $33

OAAP 777 (H24) Section on Pulmonology-Soothing Sounds from New Orleans: New Ideasin Chest DiseaseSnoring and Sleep Disorders; Croup: TheLatest in Treatment; New Inhaled Steroids inAsthma; Evaluation of Airway Difficulties(Congenital); Bronchiolitis: Fresh Ideas onTreatment; Parapneumonic Effussion...3 cassettes, $332

O3AAP 784 PLENAR SESSION AMGenetic Basis of Congenital Heart Disease;Asthma: Antileukotrients; EnvironmentalHazards; Food Allergic Reactions; Antenataland Postnatal Evaluation of UrologicalMalformations; Back to Sleep; SIDS Update by(ipper Gore)

O3AAP 785 (S401) Funny Shaped Heads: Is ItSerious? What's a Pediatrician to Do?

O3AAP 786 (S402) Dermatologic Manifestations ofInfectious Diseases

O3AAP 788 (F410) The Pediatrician's Role inPreventing Adult Heart Disease (The BogalusaHeart Study)...1 cassette, $11

O3AAP 789 (411) STDs and Related Conceems of theOlder Adolescent Male...l1 cassette, Sll

O3AAP790 413) Ingliinal Masses-Hernia,Hydrocele, Undescended Testes...1 casette, $11

O3AAP 792 (1?414) Dentistry for te Pediatrician...I cassette, $11

O3AAP 791 (1?438/F440) Psychopharmacology in theAdolescent...1 cassette, $11

O3AAP 793 (1?415) The New Neuarodiagnostic TestsWhen Are They Needed?...1 cassette, $11

O3AAP 794 PLENARY SESSION PMSchool Health Programs in Adolescent RiskBehaviors; Children Who Smoke; TeenAbsenteeism, School Dropout Behavior;Concussions in Sports; Sudden Death in Sports;

Status Epilepticus; Diabetes Control Compli-cations; Dietary Calcium

O3AAP 795 (S431) Office Approach to CommonHematological Problemns

[3AA 7118 (S439) Conunon Problemns in PediatricOrthopaedics

O3AAP 799 (1?424) After-Hour Phone Calls: NewTechnologies, New Solutions...1I cssette, $11

O3AAP 798 (F425) Office Strategies for thePediatrician Dealing withi Teen TobaccoAddiction...l1 cassette, $11

O3AAP 796 (X?426) Preparing a Child for ForeignTravel ...1 cassette, $11

O3AAP 797 (Fr427/F428) Enuresis: A PracticalApproach to Evaluation and Managemnent ofBed Wetters Over Six Years Old...1 cassette, $11

O3AAP 7100 (1?429) Neonatal Seizures...1 cassette, $11

OAAP 7101 PLENARY SESSION AMNewborn's hnnlogic nmnaturity;Cocaine Exposed Inat; InternationalAdoption; Sleep in Childhood; Developmen-tal Dysplasia of the Hip (DDH); NicotineAddiction

O3AAP 7102 (S501) Early Detection ofDevelopmental Delay

OAAP 7103 (S502) Conunon Nutritional Problemsin Children

O3AAP 7104 (FS07) Sexual Identity Confusion inAdolescents....l cassette, $11

O3AAP 7105 (FSIO) The Outpatient Treatmnent ofBurns ...1 cassette, $11

O3AAP 7106 (1?512) What to Do When Kids Say"No"...1 casette, Sll

OAAP 7107PLENARY SESSION PMUrinary Tract Infections of Febrile Infants;Dating Skin Traumna; Syncope; Update onAnti-Inflammatory Medication; RotavirusVaccine; TB Skin Testing in the Office;Rational Use of CT

OAAP 7108 (F515) Overuse Injury in ImmatureAthletes ...1 cassette, Sll

OAAP 7109 (FS16/FS17) Give It a Shot: Assessmentof nu aIoN Practices in the Office...1 cassette, $11

O3AAP 7115 (FS18) Preventive Healthi Care Issues inTeens ...1csette, $11

O3AAP 7110 (F521) Massage Therapy for Infants andChildren...l cassette, $11

32 AAP News January 1998

~~~~~~ ~~~~~~~~~~~~~~~n ~ ~ ~~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~~ ~ ~~~ ~ ~~~ ~ ~~~ ~ ~~~ ~ ~~~~~~~~~~~~ ~~~~ ~~~ ~ ~~ ~ ~~~ ~ ~~ ~ ~~ ~ ~~ ~~~ ~~~ ~~~ ~~~ ~~~ ~~~ ~~~ ~~~ ~~~~~~~~~ ~~~ ~~~ ~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~t-

I iC di:--D: K- -1 - Iv v \ . } . X L A ~\ s4gASt_ \ f _F ~~-- -K

Dear Academy Fellow:In order to fulfill the admission requirements of AAP Bylaws, you are requested to:1) carefully review the following list of new applicants forAcademy membership; and relay your reactions directyto 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 academic and pediatric cre-dentials are not in question. Comments are requested concerning possible legal and/or ethical situations of whichyou might have personal knowledge.Send any comments on the following list of new applicants to your Distnct Chairperson by February 15.

New York 3

Giuseppina Benincasa, M.D.696 Haverstraw Rd.Suffern, NY 10901-2726

Mary T. Cosgrove, D.O0.20 Riverview PlaceHastings-on-Hudson, NY 10706

Lynnette Culanculan Cukaj, M.D.502 Chelsea Cove Dr., SouthHopewell Jct.,NY 15233

Kishwar Iqbal Dhingra, M.D.2 Colonial Rd.Scarsdale, NY 10583-7710

David Feingold, M.D.696 Haverstraw Rd.Montebello, NY 10901

Maria-Angela Fusi, M.D.211 W. 56th St.,#24-HNewYork,NY 10019

Lisa F. Imundo, M.D.Columbia Pres. Medical Center3959 Broadway, BH 106NNewYork,NY 10032

Viciki Bettina Peters, M.D.Mt. Sinai HospitalPediatrics, Box 1198NewYork,NY 10029

Barbara Kathryn Russell, D.O.188 E. 76th St., #7-CNew York,NY 10021-2828

Karen L. Warman, M.D.170 E. 77th St., #8ENew York, NY 10021-1919

New JerseyLorieta Hernandez Bogdan, M.D.20 Ludlow Ave.Spring Lake, NJ 07762-1563

Francis Njeuma Mase, M.D.1586 Shadybrook Rd.Wilmington, DE 19803-4000

Nkem Vesta Nnaeto, M.D.84 Sanford St.East Orange, NJ 07960

Hanan A. Tanuos, M.D.43 Heritage Dr.East Hanover, NJ 07936-3929

PennsylvaniaChristopher J. Festa, M.D.18 Furlong Dr.Cherry Hill, NJ 08003

Jill A. Foster, M.D.Alleghany Univ. Hospital, MCP3300 Henry Ave.Philadelphia, PA 19129

Lauri Ellen Spencer Paloni, M.D.102 Gwynmont Dr.North Wales, PA 19454-1813

George J. Vilushis, D.O.5729 Larchmont Dr.Erie, PA 16509-2917

Emergency MedicineSpecialty FellowMeta Loren Podrazik, M.D.221 S. 1 2th St., #406-SouthPhiladelphia, PA 19107

Otolaryngology Specialty FellowGary David Josephson, M.D.Div. of Ped. OT/Dept. of OTD-48 ACC East Bldg., #306P.O. Box 016960Miami, FL 33101

GeorgiaRichard Gonzalez, M.D.3997 Lawrenceville Hwy., 230BLilburn, GA 30247

Thomas Edward Mellow, M.D.1019-N Oak Chase Dr.Tucker, GA 30084

Neil R. Nickelson, D.O.Bi-County Gwinnett Pediatrics976 Killian Hill Rd.Lilburn, GA 30247

KentuckyJennifer Sevier Riebel, M.D.Georgetown Pediatrics1162 Lexington Rd.Georgetown, KY 40324-9392

Patrica MaschnerThompson, M.D.4192 Heartwood Dr.Lexington, KY 40515

North Carolina

Anshu Batra, M.D.20 Copper Hill Ct.Durham, NC 27713-9447

Dean R. Meisel, M.D.8108-B Market St.Wilmington, NC 28405

South Carolina

Anne Damayanthi Fernando, M.D.81 Coach Rd.Cheraw, SC 29520-9559

Tennessee

Jerry Brooksher Gee, II, M.D.Univ. of Tenn. - MemphisDiv. of Newborn Medicine853 Jefferson Ave.Memphis,TN 38163

Gail Juanita Gossett, M.D.729 N. AvalonMemphis,TN 38107

Ralph Michael Green, M.D.613 Laurel Valley Dr.Knoxville, TN 37922-1522

Virginia

Seirin Barmada-Mazid, M.D.2101 Polo Pointe Dr.Vienna,VA 22181

Mary Bernardi Edelson, M.D.4926 Bromley LaneRichmond, VA 23226-1235

Diane R. Jacobsohn, M.D.1303 N. Ode St., #202Arlington, VA 22209

Surgery Specialty FellowRobert Edward Kelly, Jr., M.D.

*P.O. Box 11267.Norfolk,VA 23517

Abdullah T.S. Al-Turki, M.D.King Faisal Specialist HospitalPediatrics, MBC58P.O. Box 3354Riyadh, 11211Saudi Arabia

Indiana

Jeffrey Rogers Leipzig, M.D.3519 Tahoe Rd.Carmel, IN 46033

MichiganKenneth J. Fawcett, Jr., M.D.4829 E. Beltline, NE, #201Grand Rapids, MI 49505

Tarek Garada, M.D.29768 Citation Circle, #32205Farmington, MI 48331 -5896

Margaret A. Morath, D.O.B-545 W. Fee HallEast Lansing, Ml 48824

Surgery Specialty FellowJoseph Lawrence Lelli, Jr., M.D.Pediatric Surgical Assoc.F3970 Mott Children's HospitalAnn Arbor, MI 48109-0245

Ohio

Samar Haddad Bashour, M.D.2047 Farmington TurnWestlake, OH 44145-2944

Randal S. Olshefski, M.D.Columbus Children's Hospital700 Children's Dr., H/O SectionColumbus, OH 43205-2696

Angela Rambalakos Pecha, M.D.1305 Grace Ave.Cincinnati, OH 45208-2427

Alla Sherman, M.D.679 Davidson Dr.Highland Heights, OH 44143

Sheila Kay Sturgill, M.D.5170 Darrow Rd.Hudson, OH 44236

Uniformed Services East

Lisa Georgianne Rider, M.D.3104 Homewood Pkwy.Kensington, MD 20895

Ophthalmology Specialty FellowRobert Bryson North, Jr., D.O.895 Tylerton CircleGrayslake, IL 60030

Massachusetts

George LaMonte Askew, M.D.42 Stoney Run LaneMarion, MA 02738-1218

Kimberlee Fish Chatson, M.D.21 Royal Crest Dr., #10North Andover,MA 01845

Michael Gerard D'Alessandro, M.D.325 River Rd.South Hadley, MA 01075

Maria Adriana Schoen, M.D.16 Grove St., Apt. #1Westborough, MA 01581

Alabama

Bhagwan Das Bang, M.D.301 2nd Ave.Audalusia, AL 36420

Arkansas

Maria Teresa Esquivel, M.D.13916 Saddle Hill Dr.Little Rock, AR 72212

,Louisiana

*Bedford Nieves-Cruz, M.D.P.O. Box 5035Houma, LA 70361

Sheila G. Pitre, M.D.807 Ridgefield Rd.Thibodaux, LA 70301-3901

*Raymond Cachopero Poliquit, M.D.*.Delta Rural Health Services804 Beech St.P.O. Box 1528Tallulah, LA 71284-1528

.Mississippi*Dennis John Hey, D.O.1314 19th Ave.

,Meridian, MS 39301-4116

*.Texas

Kevin Lawrence Berger, M.D.2421 Southgate Blvd.

*Houston, TX 77030

Florida

Jack William Bandel, M.D.3400 NE 192nd St., Apt. 1003North Miami Beach, FL 33180

Shirley Cambell-Mogg, M.D.10710 NW 18th Ct.Plantation, FL 33322-6476

Stewart Aubrey Grant, M.D.1608 Harvard Woods Dr., #2604Brandon, FL 33511

Dewitt Benjamin Helgemo, M.D.26419 Lancer LanePunta Gorda, FL 33983

Dorlinda Varga House, M.D.3048 Alatka Ct.Longwood, FL 32779

Marc Yves-Rene Linares, M.D.11101 S.W. 71st Ave.Miami, FL 33156-3945

Ella J. Marsh, D.O.8210 Imber St.Orlando, FL 32825

Alex M. Uson, M.D.615 W. Dixie Ave.Leesburg, FL 34748

New York 1

Nader Henry Atallah-Yunes, M.D.683 E. Seneca Turnpike, #13-19Syracuse, NY 13205-2621

Noel Benitez Rosales, M.D.Crouse Pediatrics600 E. Genesee St., #217Syracuse, NY 13202

NewYork2

Mary Cappuccino Bonafede, M.D.2 Larry LaneWest Islip, NY 11795

Robert Stephen Darr, M.D.356 76th St.Brooklyn, NY 11209

Adolfo F. Grieg, D.O.1 19 Cayuga PlaceJericho,NY 11753

Pradeep Kumar Kandula, M.D.2650 Ocean Parkway, #6FBrooklyn, NY 11235

Mario J. LiPera, M.D.61 Willets Rd.Old Westbury, NY 11568

11

_ _~Wl

___r~~~~~~~~~~~~~~~~

January 1998 AA8P Neovjs 33

Minnesota

Andrea Marie Janousek, M.D.4445 Chatsworth St., N.Shoreview,MN 55126

Deborah Simson Nicholson, M.D.7508 Hyde Park Dr.Edina,MN 55439-1743

Missouri

Diane Mary Eschmann, M.D.13303 Tesson Ferry Rd., #50St. Louis, MO 63128

Catherine Ruth Remus, M.D.727 RadcliffeSt. Louis, MO 63130

Nebraska

Mark Richard Corkins, M.D.600 S. 42nd StreetBox 985160Omaha, NE 68198-5160

Wisconsin

Jeanine Marie Swenson, M.D.Mercy Regional Heart Center1000 Mineral Point Ave.Janesville, WI 53545

District of Columbia

Amelia Barranda Bautista, M.D.825 New Hampshire Ave., NW,#109Washington, DC 20037

Deleware

Ophthalmology Specialty FellowJane Covington Edmond, M.D.duPont Hospital for ChildrenDept. of Surgery1600 Rockland Rd., P.O. Box 269Wilmington, DE 19899

MarylandChristine Leila Saba, M.D.9021 Wandering Trail Dr.Potomac, MD 20854

Robert P. Wack, M.D.93 W. Green St.Westminster, MD 21157

British Columbia

Carl L. Ivey, M.D.377 Carneghe St.Campbell River, BC V9W 2J14Canada

Illinois

Hassan Alzein, M.D.10522 S. Cicero Ave., #4-DOak Lawn, IL 60453

Jonette Pangilinan Belicena, M.D.10231 S. Central Ave., #3DOak Lawn, IL 60453-4664

John W. Graneto, D.O.498 W. Belmont Ave.Chicago, IL 60657

Gwenn S. O'Keeffe, M.D.36649 N. Old Woods TrailGurnee, IL 60031

Mwk.~_S

,e- WW

Murad M. Dharani, M.D.515 S. Sugar Rd., #10Edinburg, TX 78539

Monica Herrera, M.D.1409 Pagewynne Dr.Piano, TX 75093-2633

Peter William Hine, M.D.3724 Indian Point Dr.Austin, TX 78739

Hasina Hussain, M.D.101 Sand Point Ct.Coppell,TX 75019-5359

Anesthesiology Specialty FellowJeffrey Michael Berman, M.D.UTMB, Anesthesiology301 Univ. Blvd., #2A, J.SealyGalveston, TX 77555-0591

Colorado

Deirdre Arnholz, M.D.1771 S. Quebec Way, #W202Denver, CO 80231

Ann-Christine Nyquist, M.D.780 Krameria St.Denver, CO 80220-5355

Mark G. Roback, M.D.1228 Cook St.Denver, CO 80206

New Mexico

Stanley Dav/id HandmaJ<er, M.D., Ph.D.P.O. Box 1013Corrales, NM\ 87048

OregonCharles Edward Pntchard, D.O.1825 Maple St.Forest Grove, OR 97116

Utah

Carol Sue Bruggers, M.D.1 345 S. Yuma St.Salt Lake City, UT 84108-2258

Amy Stenback, M.D.2243 Via PraviaLa Jolla, CA 92037-5841

DISTRICT IV

E. Stephen Edwards, M.D.2800 Blue Ridge Blvd.Suite 501Raleigh, NC 27607-6496

DISTRICT V

Stanford A. Singer, M.D.16800 W. Twelve Mile Rd.Suite 205Southfield, MI 48076-2138

DISTRICT VI

Ordean Torstenson, M.D.1313 Fish Hatchery Rd.Madison,WI 53715

DISTRICT VIl

Carden Johnston, M.D.Children's Hospital of Alabama1600 7th Ave., SouthSuite 001Birmingham, AL 35233-1711

DISTRICT VIII

Donald E. Cook, M.D.The Monfort Children's Clinic947 First St.Greeley, CO 80631

DISTRICT IX

Lucy S. Crain, M.D.USCSF Box 0374400 Parnassus AvenueSan Francisco, CA 94143-0374

AmericanAcademy ofPediatrics

California 1

Diane Lynne Ching, M.D.369 Warren Dr.San Francisco, CA 94131 -1033

California 2

Lauren Ashforth Dimen, M.D.212 E. Foothill Blvd.Arcadia, CA 91006

Sharada Prasad MAenon, M.D.2800 Plaza Del Amo, #210Torrance, CA 90503-9312

Elliot Taketo Sumi, M.D.3440 Lomita Blvd., #144Torrance, CA 90505

Philip Russell Vaughn, M.D.2831 Pierpont Blvd.Ventura, CA 93001

California 3

George T. Koburov, M.D.3030 Children's Way, #104San Diego, CA 92123

DISTRICT I

Gilbert L. Fuld, M.D.The Hitchcock Clinic590 Court St.Keene, NH 03431-171 9

DISTRICT 11

Louis Z. Cooper, M.D.St. Lukes Roosevelt Hospital1000 Tenth Ave.New York,NY 10019

DISTRICT III

Susan Aronson, M.D.605 Moreno Rd.Narberth, PA 19072-161 8

Arizona

Juan Alberto Gutierrez, M.D.Univ. of Arizona, HSC, Pediatrics1501 N. Campbell Ave.Tucson, AZ 85724-5073

'A..

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MNED/PEDS * Double Boarded or eligible.|The Mid-Atlantic Permanente Medical Group, P.C., a physician owned andmanaged medical group, is growing and expanding our facilities in Virginia,Maryland, and Washington, D.C. We are seeking a top quality Physician withresidency training in both Internal Medicine and Pediatrics to provide excellentservice in our modern, state-of-the-art offices. Person would be expected toteach Resident Physicians in Georgetown University's/Kaiser Permanente'sMed/Peds 4 year program. Faculty appointment at Georgetown is required.Excellent salary and benefit package including vacation and sick time,health/life benefits, malpractice coverage, retirement, relocation allowance,shareholder opportunity, and much more. Very reasonable call schedule allowsfor predicable time off. Nationally recognized for quality care, KCaiserPermanente presents an ideal opportunity. To learn more about this ideal oppor-tunity, send/fax CV to:

Dorothy Houlihan,DDPhysician Recruitment, MLAPMG, ^2101 E. Jefferson Street, Box 6649, GTz

Rockhflle,MD 20849.E d1-800-227-6472. Fax301-816-7472. KAMJER PERMANENTE

FebruaryPediatric Potpourri (E: State of the Art 1998-Maui, Hawaii, Feb. 14-20,1998. Spon-sored by the University Children's MedicalGroup, AAP California Chapter 2 (DistrictIX). Contact: Laura Thomas, 6430 SunsetBlvd., Suite 600, Los Angeles, CA 90028;(800) 3-KID-CME.

8th Dartmouth Waterville conference:"Contemporary Issues in Office Pedi-atrics" -Feb. 26 - March 1, 1998,sponsored by the AAP New HampshireChapter and Children's Hospital at Dart-mouth. Contact: Kat Barton, N.H. PediatricSociety, 45 Lyme Road, Suite 304, Hanover,NH 03755; (603) 643-2325; fax (603)643-1444; e-mail cb4maOaol.com.

Department of Pediatrics, University ofSouth Florida College of Medicine -"Gulf Coast Pediatric Conference," HolidayInn Select Hotel, Ft. Myers, Fla. Feb. 27 and28, 1998. Credit: 10 hours AAMA-1. For fur-ther information, contact Rebecca Scott,(813) 272-2744; fax (813) 272-2749.

Mamh

Pediatrics Seminar "Advances andChanging Trends" (Ninth Annual LloydNoland) -at the Buena Vista Palace, WaltDisney World, Fla., March 18-21, 1998.Faculty: Drs. Duffner, Redding, Reiter, Ruleyand Treadwell. Call/write: George M.Converse, M.D., FAAP, Department ofMedical Education, Lloyd Noland Found-ation, P.O. Box 925, Fairfield, AL 35064;(205) 783-5276.

AprilPediatrics Update (Fifth Annual LloydNoland) -Hilton Head Island, S.C., April22-25,1998. Faculty: Drs. Howard, Senac,Smith, Stockman and Weston. Call/write:George M. Converse, M.D., FAAP, Depart-ment of Medical Education, Lloyd NolandFoundation, P.O. Box 925, Fairfield, AL35064 (205) 783-5276.

Washington, D.C.: 18th Annual NationalPediatric Infectious Disease Seminar-April 15-18, 1998, Grand Hyatt,Washington, D.C. The seminar is jointlysponsored by the University of TexasSouthwestern Medical Center at Dallas,Texas, the accrediting institution, and theNational Pediatric Infectious DiseasesFoundation. CME/AAP credit offered. Forinformation you may consult the Web site:http://www.cwiweb.com/npids or call(317) 578-3075; telefax (317) 578-3802.

June

Current Concepts in Pediatric RespiratoryDiseases-June 19-21, 1998. Sponsoredby Children's Hospital in cooperation withUniversity of California, San Diego. SanDiego Hilton Beach and Tennis Resort,San Diego, Calif. Contact: (619) 576-4072; fax (619) 974-6723; e-mailoholidayEchsd.org. CME and AAFPCredits: 16.

Pediatric Infectious Disease Seminar(Sixteenth Annual Lloyd Noland)-HiltonHead Island, S.C. June 23-27, 1998.Faculty: Drs. Church, Jacobs, McIntosh,Pickering and Shulman. Call/write: GeorgeM. Converse, M.D., FAAP, Departmentof Medical Education, Lloyd NolandFoundation, P.O. Box 925, Fairfield, AL35064 (205) 783-5276.

Colorado

BE/BC Pediatrician -to join a busy prac-tice in the Colorado foothills. 1:4 callschedule, practice conveniently locatednext to the hospital. Pleasant community of30,000-35,000. Fax resume to RogerNoland, (719) 269-1730.

Florida

Tampa: Pediatric Urgent Care-Staff anddirector positions available, full- or part-time in evenings and weekend/holidayclinics. Treatments include fracture andlaceration management, intravenousrehydration and prolonged asthma therapy.Contact After Hours Pediatrics, Inc., (813)404-2023.

Pediatrician Surgeon -One-in-threecall. $150,000 + all benefits + productiv-ity. Fax c.v.: Dr. Jacobs, (914) 833-171 1;voice (914) 833-1700; (800) 333-2999.REF: 6271.

Idaho

Boise -Board Certified/Board EligiblePediatrician to join busy pediatric practice inBoise. Guaranteed salary with partnershipopportunity. Beautiful location with easyaccess to wilderness, whitewater, snow ski-ing, hunting and fishing. The Pediatricand Adolescent Center, Bill Bourquard,M.D./Tom Tilden, M.D., (208) 322-5437;Palmer Morrow, administrator, (208) 381 -

1526. Will entertain inquires now.

Illinois

Chicago -Pediatrician: BE/BC needed inNorthwest Chicago. Fluent Polish speakingis very helpful. Phone (773) 725-5400; Fax(773) 725-4707 Maria Staisz, M.D., FAAP.

University of Illinois College of Medicine-Departments of Medicine and Pediatrics

seeks an Associate Program Director at theMedicine/Pediatrics Residency TeachingProgram. We are recruiting an inter-nist/pediatrician for this Associate ProgramDirector position. The selected individualwill have administrative responsibilities inour combined Medicine/Pediatrics resi-dency. The residency is with theUniversity of Illinois College of Medicine,located at St. Francis Medical Center, themajor health care provider for NorthCentral Illinois. Candidates must hold orbe eligible for Illinois medical license, beBC or BE in internal medicine and pedi-atrics, and eligible for appointment at theUniversity of Illinois College of Medicineat the rank of Instructor, Associate orAssistant Professor. Applicant must be apersonable and enthusiastic teacher whoenjoys patient care. If interested pleasecontact: Marie Noeth, 4541 N. Prospect,4th floor, Peoria, IL 61614; (800) 438-3745; fax (309) 685-2574; or emailmarie.noeth osfheaIthcare.com

KentuckyHazard Pediatrics -needs a pediatrician inHazard, Ky., in a fairly rural setting. All can-didates welcome to apply. Send reply toHazard Pediatrics, P.O. Box 2748, Pikeville,KY 41 502-2708.

Massachusetts

Greater Boston Area -Hospital affiliatedprimary care group practice seeks BC/BEfull-time pediatrician. Excellent compensa-tion package. Please send or fax c.v. to:President, Eastern Massachusetts HealthAssociates, Inc., Hope Ave., Waltham, MAA02254; fax (781 ) 647-6188.

ton, DC 20037. The George WashingtonUniversity is an affirmative action/equalopportunity employer.

New York and Connecticut

Pediatrician -Westchester County. To$140K. 1 in 7 call. Fax c.v. to: ValerieScheck (914) 833-171 1; voice (913) 833-1700; (800) 333-2999. REF: 6222c.

Washington, DC, Maryland and VirginiaSuburbs: Primary Care Pediatricians ae TheGeorge Washington University MedicalCenter is seeking primary care pediatriciansto join GW Primary Care Associates, a mul-tidisciplinary primary care group with officeson the Medical Center campus and inMaryland and Virginia suburbs. Qualifiedcandidates must be board certified in pedi-atrics (or board eligible if within two yearsof residency completion). Primary care andmanaged care experience desired. Selectedcandidates receive faculty appointmentsand participate in primary care educationalprograms as clinical preceptors. Excellentbenefits package includes opportunity foradvanced degree with tuition benefits.Applications accepted and reviewed on anongoing basis until each vacancy in thisacademic year is filled. Send c.v. and coverletter indicating interest in Washington,D.C., suburban Maryland and/or Virginia;full-time or part-time, to ElizabethCallender, MHSA, Executive Coordinator,GW Primary Care Associates, Room G-202,2150 Pennsylvania Ave., N.W., Washing-

Accewo the best in pediatrics...

New JerseyCentral New Jersey -25+ years estab-lished solo pediatric practice/office for sale.Average gross over $200,000.00 Respondto: AAP News, Box 090197, 141Northwest Point Blvd., Elk Grove Village,IL 60007.

CIASSIFIEDADVERTISING POLICY

Whenyou need to contactpediatricians, contactAAPNews. Each month more than 53,000pediatricians,pediatricspecialists, third-yearpediatric residents and othersubscribers turn toAAPNewsforchild healthinformation theycannotget elsewhere. With a classified ad, you can speak directly to those readers.

Although theAcademy believes these classified ads are fromreputable sources, the Academy does not investigate theoffers made and assumes no responsibility concerning them.

Occassionally, it is necessary to modify the wording of classi-fied ads. These changes are generally made in compliancewith the regulations ofvarious federal and/or state commis-sions against discrimination or because they might beinterpreted as being unlawful or in conflict with accepted pro-fessional standards ofmedical practice.

These advertising modifications are made to maintain a clas-sified section that is professionally responsible, lawful,scientific and free ofdiscrimination.

AAPNEWSPublished Monthily t 2 2AmericanAcademy ofPediatrcs 1 EP.O. Box927 \ J 5ELk GroveVllage, IL 60009-0927\

Publication ofan advertisement inAAP News neither consti-tutes nor implies a guarantee or endorsement byAAP Newsor the AmericanAcademy ofPediatrics ofthe product or ser-vice advertised or of the claims made for the product orservice by the advertiser.

Classification: Classified ads are accepted under BusinessServices, General Announcements, Medical Meetings,Physicians Wanted, Positions Wanted, Practices Available,Publications, Real Estate and Residencies/FellowshipsAvailable.

DisplayClassifiedAds: Camera-ready, 4-color, 3-color and2-color display classified ads are accepted under GeneralAnnouncements, Medical Meetings, Physicians Wanted,Positions Wanted, Practices Available and Residencies/Fellowships Available. ContactAAPNews for display classifedad sizes and rates.

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January1998 AAPNews 35

Nebraska

Lincoln -Acute care, after hours pediatficclinic seeks BE/BC pediatrician. Clinic is hos-pital based, some emergency pediatrics isinvolved. Schedule allows time for personalpursuits. Good schools, low crime rate, cul-tural advantages of a university city. No J-1visa applications at this time. Contact StevePetruconis, (402) 486-7700, Saint ElizabethCommunity Health Center, 555 South70th, Lincoln, NE 68510.

North Carolina

FT or PT-Join group of four in family ori-ented community with more Fortune 500companies per population square mile thanany other county in the state! Competitivecompensation package, including resi-dency loans. Melisa Ciarrocca, (800)764-7497; fax (910) 291-7499; e-mail:mciarroccaOnconline.com.

PennsylvaniaPenn State Geisinger Health System -iscurrently seeking a BC/BE Pediatrician tojoin its multispecialty group pracffce in StateCollege, Penn. Join two other Pediatricphysicians in this busy medical practice. Callis shared with nearby sister clinic and is 1:5.Administrative opportunity available ifdesired. State College, located in the heartof Pennsylvania, is home to Penn StateUniversity. The area offers a tremendousamount of educational, cultural and recre-ational activities to enjoy. State Collegeprovides an excellent business climate andoffers a superior quality of life. We offer acompetitive salary and excellent benefitpackage. Foraddiffonal informaffon, pleasecontact: Penn State Geisinger ProfessionalStaffing (PD-AB), 100 North AcademyAve., Danville, PA 17822-1528. Phone(800) 845-7112; fax: (800) 622-2515.E.O.E. M/F/H/V.

VirginiaRichmond area -Part- /full-time BC/BEpediatrician for dynamic, growing practice.Competitive salary with eventual partner-ship. Hospitals with full service pediatrics,NICU, PICU. Attractive planned communi-ties. Excellent schools and recreationalfacilities. Nearby Medical College ofVirginia. Extremely light call. Send CV or callJudith F. McGhee, M.D., 4902 MillridgeParkway, MidlIothian, VA 231 12, (804)744-1231, orfAX (804) 744-9521.

CIHARGE ITYou can now charge yourAAPNeivs dasifiedadvertising costs on

yourVLsa orMasterCard credit cads.

So charg aheacl with yourPln to a .vffltiein

AAPNet".

ciIL _;4nXr^|f7\I-

\_.f N;t\ t4l tD. 0.

fI -asW< I"; ^r

Ew ~THIS IS AN IMPORTANT EVENT:cixteen mi'll'ion children and adolescents eachSyear are rushed to emergency departmcrnts;

followinlg serious illness and injury. As a Congressparticipant, you will seek viable ways of ens-urinathese crit'ically ill and injured ch'ildren timely, qualityemergency care.

OF THE CONGRESS:* To Re-examine Pediatric Emergency Sei-lwces i'nthe Context of Changes to the Health Care System

* To Provide a Forum for the Very Latest inEMSC-related Research*To Showcase E-ffective and IlnnovativeCommunity ProgTams

- ~WILL JOIN YOU AT THE CONGRESS:ealt Professi'onals

*Health Care Administrators*Pol'icy Makers*Health Finance and Managed Care ProuvidersvConsumers*Volunteer and Communilty Advocates

SUBSCRIPTIONINFORMATIONSubscriptions toAAP?Newscost $40 for nornmembers.To subscribe, contact:

Pete Petersen,subscriptions anld advertising

coordinator at

1(800) 433-9016, ext. 7667.

Canadian Paediatric Soci&t canadienneSooiety de pediatrie

VO s New up North?Just ask the Canadian Paediatric society

The Canadian Paediatric Society (CPS), an organization of 2,000 paedia-tricians, is Canada's foremost resource on infant, child, and youth healthissues. For nearly 75 years, we have been advocating for Canada's kids.We produce national guidelines for paediatric care and practice, providecontinuing medical education for our members, and promote the inter-ests of Daediatricians. We are regularly consulted by other health careprofessionals, govemment, media, and the public.

An invitation to members of the American AcademyOf PediatricBecause child health has no borders, we're extending a special invitationto members of the American Academy of Pediatrics.You can keep up-to-date on advances, guidelines, and activities inCanadian paediatrics by joining the Canadian Paediatric Societ-y. We'vecreated a new membership category just for AAP members.You'll benefit from membership in the CPS

With your membershipf you'll receive:* subscription to Paediatrics & Child Health, the official CPS journal* subscription to the CPS News, our bimonthly newsletter* current clinical practice guidelines of the CPS* membership listYou'll also enjoy savings on our Annual Meeting and continuing medicaleducation courses.

Contact us for details:Canadian Paediatn'c Society * Membership Services

100-2204 Walkley Road * Ottawa, Ontario Kl G 4G8Tel. (613) 526-9397, ext. 238 * Fax: (613) 526-3332E-mail: membershipOcps.ca * Internet: www.cps.ca

(Formerly -the NatAonalI Mediia Lit~eracy GConference)Juneo Z8~-July 1, 100z3

"At4 Plaradligmt fo>r Public He3al-t;h"The health and well-being of our children. is dramatically influenced by images andmessages conveyed by the media. Professionals and parents have an enormous stake inguaranteeing that the media's influence on our nation's yoth be positive. This can beaccomplished through media education, which includes deovuelopment of critical thinkingand veigsil,adofrnceative alternatives to media consumption. If our nationis to reach its goal of having a%fealthier, more productive society in the next millennium,we must move media education into schools, romes and communities.

T O~T GET MORE INFORMATION:Please call the EMSC National Resource Centerat (202) 884-4927 or eniail kallen@emsenrc.com.The Ei-nergency Med'ical Services for Children(EMSC) progra'm focuses 'its energies on all aspectsof pediatric emergency care-from in'jurypreventi'on and prehospital servzices to care inthe emergency department, rehabililtation, andreintegration 'into the community. V'isit our websiteat www.emsc.com.

I

I

ITIe National Congress onChildhood Emergenc'ies:Communibt Partnersh'ins,Cri'tical Care and Policy

Sponsored by:Emergency MedicalServilces for ChildrenMarch 22-24, 1998Renaissance HotelWashington, DC

NA--IIONALCONGRESSON CHILDHOO0DlEME RGEN CI ES

Organized and Hosted by:p,M-

Par-tnershipfor MediaEducation

A Collaboration of:American Academy of Pediatrics

Center for Media LiteracyMedia Literacy Project at Clark Universitv

Center for Substance Abuse Prevention./SAMHMA

For mo>re informatiokn abo>ut~at;teding r presen.ting cont~act-:

Conference Office2121 South Oneida Street, Suite 325

Denver, CO 80224-2552

Ph: 303 756-8380 * Fax: 303 759-8861E-mail: NsMEC980aol.com

Web Site: www.ConferenceOffice.corn/NMEC

PEDIATRIC FACULTY CRITICAL CAREThe department of Pediatrics, University of Illinois College of Medicine at Peoria (UICOM-P) is offering a

full time position in Pediatric Critical Care at the Assistant Professor, Associate Professor or Professor level.Active regional outreach and transport system and cardiac surgery programs. Significant opportunities

exist for teaching, patient care, and clinical research.Must be Board certified or Board eligible in Pediatric Critical Care Medicine. Rank and Salary commen-

surate with prior experience and qualifications.The University of Illinois is an Affirmative Action/Equal Opportunity employer. Applications will be received

until a qualified applicant is identified. Position available immediately. Send Curriculum vitae and three let-ters of reference to:

G. Kris Bysani, M.D. * Director and Chief, Section of Pediatric Critical CareUniversity of Illinois College of Medicine at Peoria * Children's Hospital of Illinois

530 N.E. Glen Oak Avenue, Peoria, IL 61637 - Phone 1 -800-438-3745 or FAX 1 -309-685-2574

OSF"A commitment to lIffe.

PEDIATRIC PRACTICEOPPORTUNITY

A single-specialty group of sixPediatricians is seeking a BC Or BEpediatrician to join them in thenewly remodeled office buildingjust two miles from OSF SaintFrancis Medical Center in historicPeoria, Illinois. Beginning patientload is 20-25 per day, with twelveexam rooms, five nurses and fiveclerical support staff members.

This position will enable you tobecome part of the OSF MedicalGroup, a network of primary carephysicians affiliated with OSFHealthcare Systems. We offeracompetitive salary and an extensivebenefits package.Peoria is locatedalong the banks of thescenic Illinois River,and has a populationof 180,000. Formore_information pleasecontact:Wendy Bass iPhysician Recruiter(800)462-3621FAX (309)685-2574or E-mail:wendy.bassWosfhealthcare.com

EBY.EBY-MAILAAPNews can now accept yourclassified advertising by e-mail!Send ads to ppetersen@aap.org

THE RIGHT CAREMfWHrE2N, IT COUNTS

ChildrerfsAsi06I| C The University of Illinois

College of Medicine at Peoria

Kitvi.01.1to*IMWi_mil t $UtL" __===AM-__ =o*vw'

Z'+h n@~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Ito(czithromycin tororulsuspension)~

ZITHROMAX°(azithromycin for oral suspension)

BRIEF SUMMARY

INDICATIONS AND USAGEZITHROMAX(¢ (azithromycin) is indicated for the treatment of patients with mild to moderate infections (pneumonia: seeWARNINGS) caused by susceptible strains of the designated microorganisms in the specific conditions listed below. Asrecommended dosages, durations of therapy, and applicable patient populations vary among these infections, please seeDOSAGE AND ADMINISTRATION for specific dosing 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, Mycoplasma pneumoniae,or Streptococcus pneumoniae in patients appropriate for oral therapy. (For specific dosage recommendation, see DOSAGEAND ADMINISTRATION.)

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 any of thefollowing: patients with cystic fibrosis, patients with nosocomially acquired infections, patients withknown or suspected bacteremia, patients requiring hospitalization, or patients with significantunderlying health problems that may compromise their ability to respond to their illness (includingimmunodeficiency or functional asplenia).

Pharyngitis/tonsillitis caused by Streptococcuspyogenesas an alternative to first-line therapy in individuals whocannot use first-line therapy. (For specific dosage recommendations, see DOSAGE AND ADMINISTRATION.)

NOTE: Penicliin by the intramuscular route is the usual drug of choice in the treatment of Streptococcus pyogenesinfection and the prophylaxis of rheumatic fever. ZITHROMAXI is often effective in the eradication of susceptible strains ofStreptococcus pyogenes from the nasopharynx. Because some strains are resistant to ZITHROMAXO, susceptibility testsshould be performed when patients are treated with ZITHROMAX(0. Data establishing efficacy of azithromycin in subsequentprevention of rheumatic fever are not available.

Appropriate culture and susceptibility tests should be performed before treatment to determine the causative organismand its susceptibility to azithromycin. Therapy with ZITHROMAX(O may be initiated before results of these tests are known;once the results become available, antimicrobial therapy should be adjusted accordingly.

CONTRAINDICATIONSZITHROMAX( is contraindicated in patients with known hypersensitivity to azithromycin, erythromycin, or any macrolideantibiotic.

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. Although rare,fatalities have been reported. (See CONTRAINDICATIONS.) Despite initially successful symptomatic treatment of theallergic symptoms, when symptomatic therapy was discontinued, the allergic symptoms recurred soon thereafter in somepatients without further azithromycin exposure. These patients required prolonged periods of observation andsymptomatic treatment. The relationship of these episodes to the long tissue half-life of azithromycin and subsequentprolonged exposure to antigen is unknown at present.

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

In the treatment of pneumonia, azithromycin has only been shown to be safe and effective in the treatinent ofcommunity-acquired pneumonia due to Chlamydia pneumonise, Haemophilus influenzae, Mycoplasmapneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy. Azithromycin should not beused in patients with pneumonia who are judged to be inappropriate for oral therapy because of moderate tosevere illness or risk factors such as any of the following: patients with cystic fibrosis, patients withnosocomially acquired infections, patients with known or suspected bacteremia, patients requiringhospitalization, elderly or debilitated patients, or patients with significant underlying health problems that maycompromise their ability to respond to their illness (including immunodeficiency or functional asplenia).

Pseudomembranous colitis has been reported with nearly all antibacterial agents and may range in severityfrom mild to life-threatening. Therefore, it is important to consider this diagnosis in patients who present withdiarrhea subsequent to the administration of antibacterial agents.

Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridia. Studiesindicate 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. Mildcases of pseudomembranous colitis usually respond to discontinuation of the drug alone. In moderate to severe cases,consideration should be given to management with fluids and electrolytes, protein supplementation, and treatment with anantibacterial drug clinically effective against Clostridium difficile colitis.

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

There are no data regarding azithromycin usage in patients with renal impairment; thus, caution should be exercised whenprescribing azithromycin in these patients.

The following adverse events have not been reported in clinical trials with azithromycin, an azalide; however, they havebeen reported with macrolide products: ventricular arrhythmias, including ventricular tachycardia and torsades de pointes, inindividuals with prolonged QT intervals.

There has been a spontaneous report from the post-marketing experience of a patient with previous history of arrhythmiaswho experienced torsades de pointes and subsequent myocardial infarction following a course of azithromycin therapy.Information for Patients: Patients should be cautioned to take ZITHROMAX" suspension at least one hour prior to a mealor 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 an allergicreaction occur.Drug Interactions: Aluminum- and magnesium-containing antacids reduce the peak serum levels (rate) but not the AUC(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 in multiple dosesresulting in therapeutic steady-state levels of theophylline is not known. However, concurrent use of macrolides andtheophylline has been associated with increases in the serum concentrations of theophylline. Therefore, until further dataare available, prudent medical practice dictates careful monitoring of plasma theophylline levels in patients receivingazithromycin 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 warfarin concomitantly.Concurrent use of macrolides and warfarin in clinical practice has been associated with increased anticoagulant effects.

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

Digoxin-elevated digoxin levels.Ergotamine or dihydroergotamine-acute ergot toxicity characterized by severe peripheral vasospasm and 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 impairedfertility due to azithromycin was found.

References: 1. Data on file. Pfizer Inc, New York, NY. 2. McLinn S, Williams D. High incidence ofStreptococcus pneumoniae and Haemophilus influenzae (beta-lactamase) resistance in recent otitis mediaclinical trial isolates. Presented at the 35th Interscience Conference on Antimicrobial Agents andChemotherapy; September 17-20, 1995; San Francisco, Calif. Abstract. 3. Hardy DJ, Hensey DM, BeyerJM, Vojtko C, McDonald EJ, Fernandes PB. Comparative in vitro activities of new 14-, 15-, and 16-membered macrolides. Antimicrob Agents Chemother. 1988;32:1710-1719. 4. Retsema J, Girard A,Schelkly W, et al. Spectrum and mode of action of azithromycin (CP-62,993), a new 15-membered-ringmacrolide with improved potency against gram-negative organisms. Antimicrob Agents Chemother.1987;31:1939-1947. 5. McLinn S. Double blind and ore label studies of azithromycin in themanagement of acute otitis media in children: a review. Pediatr Infect DisJ. 1995;14:S62-S66.6. Khurana C, McLinn S, Block S, Pichichero M. Trial of azithromycin (AZ) vs Augmentin (AUG) fortreatment of acute otitis media (AOM). Presented at the 34th Interscience Conference on AntimicrobialAgents and Chemotherapy; October 4-7, 1994; Orlando, Fla. Abstract.

Augmentin (amoxicillin/clavulanate potassium) is a registered trademark of SmithKline BeechamPharmaceuticals

Pregnancy: Teratogenic Effects. Pregnancy Category B: Reproduction studies have been performed in rats and mice atdoses up to moderately maternally toxic dose levels lie,200 mgtkg/day). These doses, based on a mg/m2 basis, areestimated to be 4 and 2 times, respectively, the human daily dose of 500 mg. In the animal studies, no evidence of harm tothe fetus due to azithromycin was found. There are, however, no adequate and well-controlled studies in pregnant women.Because animal reproduction studies are not always predictive of human response, azithromycin should be used duringpregnancy only if clearly needed.Nursing Mothers: It is not known whether azithromycin is excreted in human milk. Because many drugs are excreted inhuman 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 and effectiveness inthe 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): Safety andeffectiveness in the treatment of children with community-acquired pneumonia under 6 months of age have not beenestablished. Safety and effectiveness for pneumonia due to Chlamydia pneumoniae and Mycoplasma pneumoniae weredocumented in pediatric clinical trials. Safety and effectiveness for pneumonia due to Haemophilus influenzae andStreptococcus pneumoniae were not documented bacteriologically in the pediatric clinical trial due to difficulty in obtainingspecimens. Use of azithromycin for these two microorganisms is supported, however, by evidence from adequate and well-controlled studies in adults.

Pharyngitis/Tonsillitis (dosage regimen: 12 mg/kg on Days 1-5): Safety and effectiveness in the treatment of children withpharyngitis/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 (65-85 years old) were similar to those in younger volunteers(18-40 years old) for the 5-day therapeutic regimen. Dosage adjustment does not appear to be necessary for older patientswith 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 anid were reversible upondiscontinuation of the drug. Approximately 0.7% of the patients (adults and children) from the multiple-dose clinical trialsdiscontinued ZITHROMAXI, (azithromycin) therapy because of treatment-related side effects. Most of the side effectsleading to discontinuation were related to the gastrointestinal tract, e.g., nausea, vomiting, diarrhea, or abdominal 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 a multiple-doseregimen of ZITHROMAXO were related to the gastrointestinal system with diarrhea/loose stools (5%), nausea (3%), andabdominal pain (3%) being the most frequently reported.

No other side effects occurred in patients on the multiple-dose regimen of ZITHROMAXI with a frequency greater than1%. 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 in patientsreceiving the multiple-dose regimen.

Side effects that occurred in patients on the single one-gram dosing regimen of ZITHROMAXI with a frequency of 1% orgreater included diarrhea/loose stools (7%), nausea (5%), abdominal pain (5%), vomiting (2%), dyspepsia (1 %), and vaginitis(1 %).Single 2-gram dose regimen: Overall, the most common side effects in patients receiving a single 2-gram dose ofZITHROMAXO 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 (14%), vomiting 17%), 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, withdifferent 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 on Days 2-5, themost frequent side effects attributed to treatment were diarrhea/loose stools (2%), abdominal pain (2%), vomiting (1%), andnausea 1 %).

Community-Acquired Pneumonia: 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 treatment were diarrhea/loose stools (5.8%), abdominal pain, vomiting,and nausea 01.9% each), and rash 01.6%).

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

With either treatment regimen, no other side effects occurred in children treated with ZITHROMAXO with a frequency ofgreater 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 adult and/orpediatric patients for which a causal relationship may not be established include:Allergic: Arthralgia, edema, urticaria.Cardiovascular: Arrhythmias including ventricular tachycardia.Gastrointestinal: Anorexia, constipation, dyspepsia, flatulence, vomiting/diarrhea rarely resulting in dehydration.General: Asthenia, paresthesia.Genitourinary: Interstitial nephritis and acute renal failure.Liver/Biliary: Abnormal liver function including hepatitis and cholestatic jaundice.Nervous System: Convulsions.Skin/Appendages: Rarely serious skin reactions including erythema multiforme, Stevens Johnson Syndrome, and toxicepidermal necrolysis.Special Senses: Hearing disturbances including hearing loss, deafness, and/or tinnitus, rare reports of taste disturbances.Laboratory Abnormalities: Adults: Significant abnormalities (irrespective of drug relationship) occurring during the clinicaltrials were reported as follows: with an incidence of 1-2%, elevated serum creatine phosphokinase, potassium, ALT (SGPT),GGT, and AST (SGOT); with an incidence of less than 1%, leukopenia, neutropenia, decreased platelet count, elevated serumalkaline 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 treatment-

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

DOSAGE AND ADMINISTRATION (See INDICATIONS AND USAGE.)Acute Otifis Media and Community-Acquired Pneumonia: The recommended dose of ZITHROMAXO for oral suspensionfor the treatment of children with acute otitis media and community-acquired pneumonia is 10 mg/kg as a single dose on thefirst day (not to exceed 500 mg/day) followed by 5 mg/kg on days 2 through 5 (not to exceed 250 mg/day).Pharyngitisw7onsillitis: The recommended dose for children with pharyngitis/tonsillitis is 12 mg/kg once a day for 5 days(not to exceed 500 mg/day).ZlTHROMAX'* for oral suspension should be given at least I hour before or 2 hours after a meal.ZITllROMA)(° for oral suspension should not be taken with food.

IMore detailed professional information available on request.Revised January 1997

3A97 0 U.S. PharmaceuticalsZC17E()1997, Pfizer Inc

The antibiotic solutionwith predictable results in

unpredi"ctable patients

Predictable Coverage of

Key Pathogens:H influenzae, S pneumoniae, and

M4 catarrhalis 1-4

Predictable Results:Proven as effective as

Aulgrentin0l ,5,6+

Predictable Convenience:The only 5-day, once-daily

treat-rnent

Predic-tably VWell Tolertd

Only 0.3% discont'inuatiLon dueto side effects

The most frequent side effects are

diarrhea/loose stools (2%), abdominal pain (2%),vomiting (1%), and nausea (1%). Zithromaes

(azithromycin) is contraindicated in patients withknown hypersensitivity to azithromycin,erythromycin, or any macrolide antibiotic.

THE PREDICTABILITY YOU N EED I N PEDIATRICS 0

THE ONLY 5-D.AY ,

O1NCE~DIkLY THERAkPYFR A4lCUTE OTITIS

MEDIAT