I_;_, X c '"~-~ IiSDear 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 the following list of new applicants to your District Chairperson by July 15.

John Lovejoy, M.D.25 Charles St., Apt. 4DNew York, NY 10014

Asha Mandava, M.D.377 Rector PI., Apt. 25FNew York, NY 10280

Gary Satou, M.D.12-5 Whitetail Cir.Ossining, NY 10562

Delaware

Kathleen Bradford, M.D.Dept. of Anes & Cr Care Med.1600 Rockland Rd., Box 269Wilmington, DE 19899

District of Columbia

Mohammed Abubakar, M.D.,M.B.B.S.3030 Braxton Wood Ct.Fairfax, VA 22031

Christina Johns, M.D.2711 Hambleton Rd.Riva,MD21140

Kristin Miller, M.D.2823 27th St.. NW, #2Washington, DC 20008

MarylandSurgery Specialty FellowAnne Fischer, M.D.250 S. President St., #1200Scarlett Plc.Baltimore, MD 21202

New JerseyShahzad Khan, M.D.5 Las Brisas Blvd.Voorhees, NJ 08043

Jerry Mabagos, M.D.212 Greenwood Loop Rd.Brick, NJ 08724

Amisha Malhotra, M.D.127 Primrose Ct.Belle Mead, NJ 08502

Kevin Slavin, M.D.Pediatric Infectious Diseases30 Prospect Ave..Hacker,sack, NJ 07601

Carmelina Tirri, M.D.377 Saw Mill Rd.North Haledon, NJ 07508

PennsylvaniaUwe Blecker, M.D.Pediatric GastroenterologyErie Ave. at Front St.Philadelphia, PA 19134

William King, M.D.663 Parkview Blvd.Yeadon, PA 19050

Chinedum Udenze-Utah, M.D.120 Muirfield Dr.Blue Bell, PA 19422

Shafqat Sayeed, M.D.20 Chandni Chowk St.Calcutta 70072India

Iram Jafri, M.D.Block 53, Apt. #FF-2Sea View Apts, Phase V Ext.Defence Housing AuthorityKarachiPakistan

Connecticut

Norine Kanter, M.D.76 Seminole Cir.W. Hartford, CT 06117

Massachusetts

Stephen Porter, M.D.24 Beaufort Rd., #2Jamaica Plain, MA 02130

Inger-Marie Pu, M.D.10 Vinson Cir.Winchester, MA 01890

Amit Rakhit, M.D.192 W. Canton St., #1Boston, MA 02116

Cathy Scheiner, M.D.31 Phillips St.Watertown, MA 02472

Uniformed Services-East

Rosemarie Dieffenbach, M.D.PSC 827 Box 4864FPO, AE 09617

Vermont

Michelle Perron, M.D.34 Colonial Dr.Montpelier, VT 05602

New York 1

M. Arigo, M.D.174 Hammocks Dr.Fairport, NY 14450

Eric Beyer, M.D.162 Thad Chapin St.Canandaigua, NY 14424

Mahesh Bommaraju, M.D.368 Deerhurst Park Blvd.Tonawanda, NY 14223

Byra Reddy, M.D.955 Kieff Dr.Watertown, NY 13601

NewYork2

Araceli Dantes, M.D.23 Viking Dr.West Islip, NY 11795

Ann Marie Yu, M.D.1203 Estates Ln., Apt. #1Bayside, NY 11360

NewYork 3

Gilbert Herzberg, M.D.8 Coolidge St.Larchmont, NY 10538

Lori Legano, M.D.210 E. 15th St., #5-ANew York, NY 10003

Christina Neeley, M.D.236 W. Second St.Ocean Isle Beach, NC 28469

Christa Thornberry, M.D.106 Norfleet Ct.Tarboro, NC 27886

South Carolina

Rathna Amarnath, M.D.9 Richland Medical Pk., #2Columbia, SC 29203

Stacy Garmon, M.D.124 Creek Dr.Easley, SC 29642

Tennessee

Lori Breaux, M.D.521 Fairhaven Ct.Nashville, TN 3721 1

Julissa Corredor, M.D.247 Wildberry Ln.Nashville, TN 37209

Bruce White, M.D.3443 Dickerson Pike, Ste. 370Nashville, TN 37207

VirginiaMarshall Dews, M.D.P.O. Box 81Belle Haven, VA 23306

OregonBarbara Sibley, M.D.4897 Santa Barbara Dr.Medford, OR 97504

Utah

John Wynn, M.D.171 N. 400W, Cl2Orem, UT 84057

WashingtonDavid Buchholz, M.D.1100 E Harrison St., #402Seattle, WA 98102

California 1

Flordelina Arroyo, M.D.221 Sunset Dr.Hercules, CA 94547

Sarah Cahn, M.D.4382 Howe St., #2Oakland, CA 94611

California 2

Michael Culmer, M.D.26530 Deepbrook Dr.Rancho Palos Verdes, CA 90275

Grace Kim-Abroms, M.D.806 Murray St.San Luis Obispo, CA 93405

Cara Todd, M.D.1233 Somerset Ln.Newport Beach, CA 92660

California 3

Alice Pong, M.D.5116 Via ValartaSan Diego, CA 92124

California 4

Valery, Brouwer, M.D.28361 Silverton Dr.Laguna Niguel, CA 92677

Alabama

Karen Franks, D.O.3402 Buck Horn CoveBirmingham, AL 35242

Florida

Jean-Daniel Pierrot, M.D.2203 Lake Debra Dr., Apt. 124Orlando, FL 32835

Orlando Rendon, M.D.518 Oakmont Dr.0Qrange Park, FL 32073

Danita Wongchantara, M.D.6040-D Lynn Lake Dr. SrSaint Petrkiersug FL 33712

Georgia

lyabode Akinsanya-Beysolow,M.D., M.P.H.4591 Cherie Glen Trl.Stone Mountain, GA 30083

Ophth7almology SpecialtyFellowStephen Lipsky, M.D.4457 Huntington Cir.Atlanta, GA 30338

Iowa

Daniel Wright, D.O.125 Midlothian Blvd.Waterloo, IA 50701

Minnesota

Paul Kubic, M.D.347 N. Smith Ave.Saint Paul, MN 55102

Lisa Oie, M.D.16769 Jackpine Trl.Lakeville, MN 55044

Surgery Specialty FellowDavid Rodeberg, M.D.1905 Glendale Hills Dr. NERochester, MN 55906

Missouri

Orthopaedics Specialty FellowKevin Latz, M.D.Dept. of Orthopaedic Sgy.2401Gillharn Rd.Kansas .City, MO 64108

Nebraska

Gina DiRenzro-Coffey, M.D.6220 California St.Omaha, NE 68132

Wisconsin

Steven Leuthner, M.D.8701 Watertown Plank Rd.MS 213AMilwaukee, WI 53226

Louisiana

Tracy Conrad, D.O.22 Olympic Ct.New Orleans, LA 70131

Oklahoma

Ayesha Ahmad, M.D.207 Tommye Ln.Tahlequah, OK 74464

Texas

Jeffrey Berkowitz, M.D.6304 Brimwood Dr.Plano, TX 75093

Luella Guzman, M.D.P.O. Box 1797Pasadena, TX 77501

Surgery Specialty FellowJeffrey Horwitz, M.D.5217 Old Spicewood Springs Rd.#613Austin, TX 78731

Surgery Specialty FellowAlexander Soutter, M.D.241 Mitchell St.Corpus Christi, TX 78411

_1'1 Lek

Alberta

Cara Dosman, M.D.1 1307 99th Ave., #410Edmonton, AB T5K OH2Canada

Hawaii

Jeffrey Becker, M.D.1429 Ihiloa LoopHonolulu, Hi 96821

DISTRICT I

Eileen M. Ouellette, M.D., J.D.Pediatric NeurologyNorth Shore Children's Hospital57 Highland Ave.Salem, MA 01970e-mail: eouelletteOaap.org

DISTRICT 11

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

DISTRICT III

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

DISTRICT IV

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

DISTRICT V

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

DISTRICT VI

Kathryn Piziali Nichol, M.D.1314 Morrison St.Madison, WI 53703e-mail: knicholEaap.org

DISTRICT Vll

L. Leighton Hill, M.D.Office of AdmissionsBaylor College of MedicineOne Baylor Plaza, Rm. N104Houston, TX 77030e-mail: IhillQaap.org

DISTRICT Vlill

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

DISTRICT IX

Burton F. Willis, M.D.1 1 160 Warner Ave.Suite 101Fountain Valley, CA 92708e-mail: bwillisOaap.org

DISTRICT X

Charles Linder, M.D.Medical College of Georgia1 120 1 5th St.Rm HF1117Augusta, GA 30912e-mail: clinderOaap.org

Michigan:PeterJennings, M.D.Dept. of Peds and HumanDevelopmentB240 Life Sciences Bldg.East Lansing, Ml 48824 :

Jeffrey Taub, M.D.:1193 PierceBirmingham, MI 48009 d

Jihad Younes, M.D.One Lafayette PlaisanceApt. 413Detroit, Ml 48207:

Ohio:Sheela Geraghty, M.D.1650 Beach Grove Dr.Cincinnati, OH 45233

Demetrio Macariola, M.D. :3815 Brotherton Rd., #2 :Cincinnati, OH45209:

Maroun Mhanna, M.D.6805 Mayfield Rd., #926Mayfield Heights, OH 44124

Dagmar Stein, M.D., Ph.D. :2521 Underhill Rd.:Toledo, OH 43615:

Illinois

Isabelle De Plaen, M.D. e2424 N. Clark St., #315Chicago, IL 60614:

Jennifer Kahn, M.D.:9343 Central Park Ave.Evanston, IL 60203

Padmanabhan Mukundan, M.D.Dept. of Fam. Medicine&:Cmnty Health:1500 S. California Ave., #F1006:Chicago, IL 60608

North Carolina

Surgery Specialty FellowRobert Lefton, M.D.1305 Hunterswood Dr.Winston-Salem, NC 27104

David Mertz, M.D.518 Parkview Dr.Burlington, NC 27215

June 2001 AAP News 287

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Although theAcademy believes these classified ads are from rep-utable sources, theAcademy does not investigate the offers madeand assumes no responsibility concerning them.

Occasionally, it is necessary to modify the wording of classifiedads. These changes are generally made in compliance with theregulations ofvarious federal and/or state commissions againstdiscrimination or because they might be interpreted as beingunlawful or in conflict with accepted professional standards ofmedical practice.

These advertising modifications are made to maintain a classifiedsection that is prbfessionally responsible, lawful, scientific andfree of discrimination.

Publication ofan advertisement inAAP News neither constitutesnor implies a guarantee or endorsement by AAP News or theAmericanAcademy of Pediatrics of the product or service adver-tised or of the claims made for the product or service by theadvertiser.

Classification: Classified ads are accepted under BusinessServices, GeneralAnnouncements, Medical Meetings, PhysiciansWanted, Positions Wanted, Practices Available, Publica- tions,Real Estate and Residencies/ Fellowships Available.

Display Classified Ads: Camera-ready, 4-color, 3-color and 2-color display classified ads are accepted under GeneralAnnouncements, Medical Meetings, PhysiciansWanted, PositionsWanted, Practices Available and Residencies / FellowshipsAvailable. Contact Roland Keve, TheWalchliTauber Group for dis-play classified ad sizes and rates.

Formore information, contact: Roland KeveX TheWalchliTauberGroup, (410) 420-0311, or fax (410) 420-0711. Ad copy is to besent to: TheWalchliTauber Group, I112W. PennsylvaniaAve., Ste.201, Bel Air, MD 21014. Payments are to be mailed and madepayable to The American Academy of Pediatrics, Dept. 77-5194,Chicago, IL 60678-5194.

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288 AAP News June 2001

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

ZITHROMAXle{azithromycin for oral 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 applicable patient populations vary among theseinfections, please see DOSAGE 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 infiuenzae, Mycoplasmapneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy. (For specific dosagerecommendation, see DOSAGE AND 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 anyof the following: patients with cystic fibrosis, patients with nosocomially acquiredinfections, patients with known or suspected bacteremia, patients requiring hospitalization, orpatients with significant underlying health problemis that may compromise their ability torespond to their illness (including immunodeficiency orfunctional asplenia).

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

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

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

CONTIRAINDICATIONSZITHROMAX' is contraindicated in patients with known hypersensitivity to azithromycin, erythromyc'in, or anymacrolide antibiotic.

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

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

In the treatment of pneumonia, azithromycin has only been shown to be safe and effective in the tireat-ment of community-acquired pneumonia due to Chlsmydia pneumonise, Haamophilus influenzae,AMycoplasmapneumoning, or Streptococcuspneumonia& in patients appropriate for oral therapy.Azithromycin should not be used in patients with pneumonia who are judged to be inappropriate for oraltherapy because of moderate to severe illness or risk factors such as any of the following: patients withcystic fibrosis. patients with nosocomially acquired infections, patients with known or suspectedbacteremia, patients requiring hospitalization, elderly or debilitated patients. or patients with significantunderlying health problenms that may comnpromise their ability to respond to their illness (includingimmunodeficiency orfunctional asplenia).

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Laboratory Test btactions: There are no reported laboratory test interactions.Camcinogenois, Mlitage esis, Impairment of Fhrtility: Long-term studies in animals have not been performed toevaluate carcinogenic potential. Azithromnycin has shown no mutagenic potential in standard laboratory tests: mouselymphoma assay, human lymphocyte clastogenic assay, and mouse bone marrow clastDgenic assay.No evidence of impaired fertility due to azithromycin was found.PregnanW. 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

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

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

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

PharyngitislTonsillitis (dosage regimen: 12 mg/kg on Days 11-5): Safety and effectiveness in the treatment ofchildren with pharyngitis/tonsillitis under 2 years of age have not been established.

Studies evaluating the use of repeated courses of therapy have not been conducted.Geriatric Use: Pharmacokinetic parameters in older volunteers (65-85 years old) were similar to those in younger vol-unteers (I18-40 years old) for the 5-day therapeutic regimen. Dosage adjustment does not appear to be necessary forolder patients with normal renal and hepatic function receiving treatment with this dosage regimen.

ADVERSE REACTIONSIn clinical trials, most of the reported side effects were mild to moderate in severity and were reversible upondiscontinuation of the drug. Approximately 0.7% of the patients (adults and children) from the multiple-dose clinicaltrials discontinued ZITHROMAXI (azithromycin) therapy because of treatment-related side effects. Most of the sideeffects leading to discontinuation were related to the gastrointestinal tract, e.g., nausea, vomiting, diarrhea, orabdominal pain. Potentially serious side effects of angioedema and cholestatic jaundice were reported rarely.Clinical: Adults: Multiple-dose regimen: Overall, the most common side effects in adult patients receiving amultiple-dose regimen of ZITHROMAX' were related to the gastrointestinal system with diarrhea/loose stools (5%),nausea (3%1. and abdominal pain (3%) being the most frequently reported.

No other side effects occurred in patients on the multiple-dose regimen of ZITHROMAX' with a frequency greaterthan 1%. Side effects that occurred with a frequency of 1% or less included the following:Cardiovascular Palpitations, chest pain.GasitrointeAtnal: 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 regimea. 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 inpatients receiving the multiple-dose regimen.

Side effects that occurred in patients on the single one-gram dosing regimen of ZITHROMAXI with a frequency of1% or greater included diarrhea/loose stools (7%), nausea (5%), abdominal pain (5%), vomiting (2%), dyspepsia (1%),and vaginitis (11%).Single 2-gram dose regimen: Overall, the most common side effects in patients receiving a single 2-gram dose ofZITHROMAXI were related to the gastrointestinal system. Side effects that occurred in patients in this study with afrequency of 1% or greater included nausea ll 8%), diarrhea/loose stools (114%), vomiting (7%), abdominal pain (7%),vaginitis (2%), dyspepsia (11%), and dizziness l1%). The majority of these complaints were mild in nature.Children: Multiple-dose regimens, The types of side effects in children were comparable to those seen in adults,with different incidence rates for the two dosage regimens recommended in children.

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

Community-Acquired Pneumonia: For the recommended dosage regimen of 10 mg/kg on Day 1 followed by5 mg/kg on Days 2-5, the most frequent side effects attributed to treatment were diarrhea/loose stools (5.8%),abdominal pain, vomiting, and nausea (1.9% each), and rash (11.6%).

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

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

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

DOSAGE AND ADMINISTRATION (See INDICATIONS AND USAGE)}Acute Oddts Media and Conmnnity-Acquired Pneumonia: The recommended dose of ZITHROMAXI for oral sus-pension for the treatment of children with acute otitis media and community-acquired pnveumonia is 10 mg/kg as asinvgle 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).Plearyngitis/Tonsillitis: The recommended dose for children with pharyngitis/tonsillitis is 12 mg/kg once a day for 5days (not to exceed 500 mg/day).ZDTNROAO for oral s_soion should be given at least I hlour bfrm or 2 bows after a m_LlZITHRO IW r oral suspesion shol not be taken wit hfeeFor more detailed professional informnation please refer to the full prescribing information.Revised July 2000

ZC225AOO

June 2001 AAP News 28O9

SOUTHEAST

BC/BE Pediatrician For A Busy Practice Northof Atlanta -Competitive salary/bonus/ben-efit package. Send CV to: Anne, P.O. Box1269, Canton, GA 30114.

ENERGETIC BC/BE PEDIATRICIAN WANTEDto join dynamic academically-oriented,nationally respected practice in Dade,Broward and Palm Beach County, Florida.Unparalleled lifestyle for primary care pedi-atrician with exceptional salary and bene-fits. Reply to: Pediatric Associates, PA, 4620N. State Rd., 7 Suite 316, Lauderdale Lakes,FL 33319, Attention: Peter Shulman, M.D.,Physician Recruiting, or fax a current CV to(954) 967-2624.

PEDIATRIC NEPHROLOGIST - The Depart-ment of Pediatrics at the University of FloridaHealth Science Center - Jacksonville seeks aPediatric Nephrologist at the non-tenureClinical Associate Professor/Clinical Professortrack level to join a busy Pediatric Nephrologydivision. Clinical activities include: inpatientconsultation, outpatient clinic, chronic hemoand peritoneal dialysis unit. Clinical researchis encouraged. The applicant should be pedi-atric board and Nephrology sub-board eligi-ble/certified. Recruiting deadline is July 31,2001, with an anticipated start date of Aug.27, 2001. Salary is negotiable. Forward letterof intent, curriculum vitae, and the namesand addresses of three references to: Asad

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August - The Cleveland Clinic FoundationDivision of Pediatrics presents the SeventhAnnual Pediatric Board Review August 27-31, 2001, at the Wyndham Cleveland Hotelin Cleveland, Ohio. For further information,

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(3: 2000 Pfizer Inc.

(ficac tht' eas for your little patent totak !)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 H influenzae, M catarrhalis, or Spneumoniae, and community-acquired pneumonia due to Cpneumoniae, Hinfluenzae, Mpneumoniae, or Spneu-moniae.Oral azithromycin should not be used in pediatric patients with pneumonia who are judged to be inappropriate fororal therapy because of moderate to severe illness or risk factors such as any of the following: patients with cys-tic tibrosis, patients with nosocomially acquired intections, 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 immunodeticiency or tunctional asplenia).

Please see briefsummary ofprescribinginformation on adjacent page.