NEVV FELLOVVS'X ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ lml,lw;riiil

Melissa Goldstein,M.D., FAAPMoscow 103104Russia

Connecticut

Christina Kozar, D.O., FAAPEast Granby, CT06026-9563

Michelle Watson,M.D., FAAPWaterford, CT 06385-3426

Massachusetts

Childsy Art, M.D., FAAPWilliamstown, MA01 267-2532

Magda Czerkawska,M.D., FAAPW Springfield, MA01 089-1 630

Susan Kirsch, M.D., FAAPBedford, MA 01730

New Hampshire

Gus Emmick, M.D., FAAPManchester, NH031 04-6489

Uniformed Services-East

Amy Marlow, M.D., FAAPBeavercreek, OH45431 -2503

Jeffery Porter, D.O., FAAPWashington, DC20009-6591

New York 1

Wayne Leavitt, M.D., FAAPCamillus, NY 13031-1498

Amy McGarry, M.D., FAAPLake George, NY 12845

NewYork2

Cesar Arias, M.D., FAAPLido Beach, NY 11561-5107

Dinesh Giliyar, M.D., FAAPLefrak City, NY 11368

Surgery Specialtny FellowMarc Levitt, M.D., FAAPNew Hyde Park, NY 11040

Monica Melamedoff,M.D., FAAPJericho, NY 11753-2115

AnanthasekarPonnambalam, M.D., FAAPBrooklyn, NY 1 1230-4139

list. In submitting these names of board-certified pediatricians to you, it is understood thatacademic and pediatric credentials are not in question. Comments are requested concerningpossible legal and/or ethical situations which you might have personal knowledge.Send any comments on the following list of new Fellows to your District Chairperson.

Dear Academy Fellow:In order to fulfill the admission requirements of AAP Bylaws, you are requested to:Carefully review the following list of new Fellows for Academy membership; and relay yourreactions directly to your District Chairperson, whose name and address is at the end of this

.:KentuckyStephanie Luellen,:M.D.,FAAP*Owensboro, KY:42303-9639

:North Carolina

:Julie Byerley, M.D., FAAP*Chapel Hill, NC 27514

*Justina Clemons,:M.D.,FAAP*Davidson, NC 28036-7837

*Jennifer Hudson,:M.D.,FAAP*Salisbury, NC 28144-3255

*William Lagarde,:M.D.,FAAP*Chapel Hill, NC:27516-4480

:Hesham Tawakol,*M.D.,FAAP*Wilmington,NC28412

:Tennessee

:Jerard Connors, M.D., FAAPKnoxville, TN 37922-8069

*Casilda Hermo, M.D., FAAP*Nashville, TN 37215-6126

:Toni Whitaker, M.D., FAAP*Memphis,TN 38105-5003

*Virginia

*Jody Kroon, M.D., FAAP*Norfolk, VA 23508-1117

:Kathleen Lundgren,.M.D.,FAAP:Alexandria, VA22305-2671

:Richard A. Salerno,*M.D.,FAAP.Charlottesville,VA22901

:Sein Win, M.D., FAAP*Falls Church, VA:22044-2031

.Saira Waheed, M.D., FAAP*Columbus, IN 47201

.Michigan

* Monica Randles,: M.D.,FAAP. Grand Rapids, Ml 49503

. Ohio

* Maria Carmen Diaz,: M.D.,FAAP* Copley, OH 44321 -2716

* Cheryl Huffman,: M.D.,FAAP. Toledo, OH 43614-5809

* _~V1

:Arkansas

:CardiologySpecialtyFellow*Jonathan Drummond-:Webb, M.D., FAAP*Little Rock, AR 72202

*Donna Graham,:M.D.,FAAP*Little Rock, AR 72205-2175

*Anesthesiology Specialty:Fellow*Shahid Hussain, M.D., FAAP.Little Rock, AR 72223

:Louisiana

Rachel Chatters,:M.D.,FAAP*.Lake Charles, LA*70605-5182

*Elaine Goldhammer,:M.D.,FAAP*New Orleans, LA:70114-8216

*George Schwartzenburg,:M.D.,FAAP*.Baton Rouge, LA.70817-3924

*Texas

*Anastasia Gentles,:M.D.,FAAP*Manchaca, TX 78652-3044

Karen Jahnke, M.D., FAAP*Corsicana, TX 75110

Kirsten Kienstra,:M.D.,FAAP*Houston, TX 77004-2795

*M. Regina Lantin-Hermoso,:M.D.,FAAP*.Houston, TX 77025-1115

*Marjorie Quarles,:M.D.,FAAP:The Woodlands, TX*77381-6154

:Marita Rafael, M.D., FAAP*Corpus Christi, TX 78414

*Cassandre Royer,:M.D.,FAAP:San Antonio, TX.78258-3180

*Arizona

*Sandra Herron, M.D., FAAP*Tucson, AZ 85741-2519

:Jean Mullen, M.D., FAAP*Gilbert, AZ 85234-8523

*Colorado

*Robert Byerly, M.D., FAAP:Grand Junction, CO*81503-1013

:Barbara Calkins,.M.D.,FAAP*.Aurora, CO 80015-5131

*Ronald Famiglietti,:M.D.,FAAP*.Steamboat Springs, CO*80488

*Hawaii

*Nadezna Lyn Ang,:M.D.,FAAP*Hilo, HI 96720-6029

.Laura Mulreany,:M.D.,FAAP*Kailua, HI 96734

*Montana

*Stephen Evans, M.D., FAAPKalispell, MT 59901

:Nevada

:Paul Smith, M.D., FAAP*Las Vegas, NV 89147

.Andrea Sorensen,*M.D.,FAAP:Reno, NV 89503

New Mexico

*Karen Salter, M.D., FAAP*Roswell, NM 88201

Uniformed Services-West

:Daren Carling, M.D., FAAP*Enid, OK 73703

:Jeffrey Hutchinson,.M.D.,FAAP*San Antonio, TX 78258

*Washington

:Lisa Marie Barer,:M.D.,FAAP*Olympia, WA 98502

:Russell Saneto,*D.O., Ph.D., FAAP*Brier,WA98036

*Janet Schairer, M.D., FAAP*Egg Harbor, NJ 08215

*New York 3

*Barbara Anderson,.M.D.,FAAP*Baltimore,MD21210

.Beverly Hay, M.D., FAAPBethesda, MD 20814-1413

:Elena Gazzola-Kraenzlin,.M.D.,FAAP*Rye, NY 10580-2015

*Neurological Surgery:Specialty Fellow*.Howard Weiner,:M.D.,FAAP*New York, NY 10016

:Maryland

:Anusha Hemachandra,*M.D., M.RKH, FAAP:Baltimore, MD21231

:Natella Rakhmanina,*M.D.,FAAP*Rockville, MD 20852

:Christine Reilly, M.D., FAAP*Sykesville, MD 21784-7710

*NewJersey

*Marilou Romero-Reyes,:M.D.,FAAP*Jackson, NJ 08527

.Susanna Scafidi,:M.D., FAAPClifton, NJ 07013-1541

*Laurie Trosin, M.D.,FAAPRingoes, NJ 08551 -1711

Pennsylvania

:Rebecca Baum, M.D., FAAPState College, PA:16803-1804

:Michael Faust, M.D., FAAP*Washington, PA:15301 -3839

:Duy Nguyen, M.D., FAAP*Uniontown, PA:15401 -3225

:Migdalia Resto, M.D., FAAP*Bethlehem, PA 18020

* Kristin Roye, M.D., FAAP* Haverford, PA 19041 -1541

: Samir Shah, M.D., FAAP* Philadelphia, PA: 19144-5356

: EdnaVianzon, M.D.,FAAP: Coraopolis, PA 15108

:Susan Wiley, M.D., FAAP*Cincinnati, OH 45208-1765

.Illinois

.Gabriel Aljadeff,:M.D.,FAAP*Northbrook, IL 60062-7673

*Craig Batterman,:M.D.,FAAP*Springfield, IL 62794-9658

*Arthur Cheng, M.D., FAAPNaperville, IL 60563

:Julan Crane, D.O., FAAP*Fairfield, IL 62837-1106

.Mary Jones, M.D., FAAP:Country Club Hills, IL*60478-5817

.Joel Manaligod, M.D., FAAPPeoria, IL 61615

:Susie Ohr, M.D., FAAP*Glenview, IL 60025-2471

*Jennifer Schening,:D.O.,FAAP*Loves Park, IL 60123

*Iowa

Lori Christensen,:M.D.,FAAP*Iowa City, IA 52246-2253

*Minnesota

.LoraTruckenbrod,:M.D.,FAAP*Minneapolis, MN 55416

*Missouri

*Susannah Ford, M.D., FAAPKansas City, MO 64108

:Andrew White, M-.D., FAAPSt Louis,MO63110

North Dakota

*Mohammad Osman,.M.D., FAAP.Minot, ND 58701

.Wisconsin

.Brett Linzer, M.D., FAAP

.Oconomowoc, WI153066

. Peter Roloff, M.D., FAAP* Neenah, WI 54956-4985

* GracielaVilladoniga,: M.D.,FAAP* Milwaukee, WI153204

California 1

*Juliana Damon, M.D., FAAP.Oakland, CA 94611

.Neurological SurgerySpecialty Fellow:Stephen Huhn, M.D., FAAP*Menlo Park, CA 94025

*Surgery Specialtny Fellow:Kerilyn Nobuhara,*M.D.,FAAP:San Francisco, CA.94143-0570

*PennyWestney,:M.D.,FAAP.Santa Rosa, CA 95403

188 AAPNews www.aapnews.org April2003

I

NEVV FELLOVVS

*Kay Tomashek, M.D., FAAP*Decatur, GA 30030-4204

:Puerto Rico

:Keyla Pratts-Rodriguez,*M.D., FAAP.San Juan, PR 00923-3021

*DISTRICT I

*Eileen M. Ouellette, M.D., J.D..Pediatric NeurologyNorth Shore Children's

.Hospital57 Highland Ave.:Salem, MA 01970-2197,e-mail: eouelletteEaap.org

*Bethany Mohr, M.D.,*Gainesville, FL 3260E

:Robert Paton, M.D.,*Jacksonville, FL 3221

.Jerome Smith, M.D.,:Wesley Chapel, FL.33543-6452

Bhumi Upadhyay,:M.D.,FAAPSaint Petersburg, FL:33707-2731

:Tai Fung Yang, M.D.,Rockledge, FL 32955

.Georgia

|Reshma Chugani,:M.D., FAAP*Atlanta, GA 30319-

*Jennifer Kottra, D.O..Martinez, GA 30907

DISTRICT IIRobert M. Corwin, M.D.Medical Director- MedBest251 Salina Meadows Pkwy.Suite 100Syracuse, NY 13212-4572e-mail: rcorwin?aap.org

DISTRICT III

Alan E. Kohrt, M.D.Medical Director/Children's Health NetChildren's Hospital ofPhiladelphia34th and Civic Center Blvd.Philadelphia, PA19104-4399e-mail: akohrt?aap.org

: DISTRICT IV

: 2706 Medical: Goldsboro, N,

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00

0

.DISTRICT V

*Ellen Buerk, M\:Oxford Pediat*5141 Morning:Oxford,OH 4*e-mail: ebuerk

.DISTRICT VI

*Kathryn Piziali:1314 MorrisorMadison, WI

:e-mail: knicho

:DISTRICT Vll

:Gary Q. Peck,*Office of Publ:325 Loyola Av*Suite513:New Orleans,*70112-1829*e-mail: gpeck(

DISTRICT Vll

.Jon R. Almqu:Virginia Masc*Center:Departmentz*33501 FirstV:Federal Way,*98003-6208.e-mail: jalmqi

:DISTRICT IX

:Burton F. Will*9900 Talbert:Suite 201*Fountain Vall,:92708-5153*e-mail: bwilli!

*DISTRICT X

California 2

Pasadena, CA 91101

Sherman Oaks, CA91423 -3217

Neurological SurgerySpecialty FellowDaniel Won, M.D., FAAPLoma Linda, CA92354-3833

California 4

Asha Dutt, M.D., FAAPAnaheim, CA 92807

Florida

Carolyn Leedy, M.D., FAAPTampa, FL 33647-1629

., FAAP8-4148

FAAP17

,FAAP

JiSt, M.D.on Medical

of PediatricsAlay South,WA

juisthaap.org

A\.D.tricsgSun Rd.65056-9722kWaap.org

Nichol, M.D.In St.53703-3812)I?aap.org Ilis, M.D.

ley, CA

isWaap.org

., FAAP5-2141

M.D.lic Healthvenue

,LA

:Eaap.org5242

>., FAAP7-4902

* Charles Linder, M.D.: Medical College of Georgia* 1120 15th St.: Rm. HF1117. Augusta,GA30912-0004* e-mail: clinderWaap.org

oe, Jr., M.D.dl Office PlaceIC 27534-9460rdsWaap.org

April2003 www.aapnews.org AAPNews '189

7\ ..-. 1-1 -1CL.f p"k- I-p-, IJ ( C D dA. I::.D)tc-t-

A CME Meeting in Practical Pediatric Topics

q MAYO CLINIC

CHILD ABUSE PROGRAM DIRECTORMayo Clinic

Mayo Medical SchoolRochester, Minnesota

The Mayo Clinic seeks a physician Director for our Child Abuse Program. The Director wouldcoordinate other physicians, psychologists, and nurse practitioners on the Child Abuse/NeglectAdvisory Team. The well-established program has an experienced LICSW serving as the ChildAbuse Coordinator with whom the Director will work. Clinical and educational opportunitiesexist with Mayo's Pediatric, Family Medicine, Psychiatry, Psychology, and Emergency Medicinefaculty and residents, as well as with Mayo Medical School students and allied health staff. Thecandidate will represent Mayo in child abuse/neglect related matters on a regional, state, andnational level.

Mayo Clinic provides excellent career opportunities through our large outpatient clinical practice;the comprehensive Mayo Eugenio Litta Children's Hospital, and our commitment to educationand research. Mayo Clinic offers the advantages of a renowned medical center with a successfulintegrated group practice in a very attractive Midwestern locale with a population of 125, 000.

The position would be divided between the Child Abuse Program and clinical work in theprimary specialty area in which the candidate is trained. Candidates may come from one ofthefollowing clinical disciplines: Pediatrics, Psychiatry, Family Medicine, Behavior/Development,or Emergency Medicine.

Qualified individuals should forward their curriculum vitae and letters of interest to the chair ofthe search committee:

Jay L. Hoecker, M.D.Interim-Director, Mayo Child Abuse Program and Search Committee Chair

Mayo Clinic200 First Street, SW

Rochester, MN 55905

(507) 284-5247(Fax: 507-284-9744)

Mayo Foundation is an af7irmative action and equal opportunity educator and employer.

l~~~~

I--~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Friday and Saturday, May 16 and 17, 2003

This course is designed to:1) Provide an update in the clinical, genetic and basic

science issues relating to vascular anomalies.2) Discuss specific controversial management issues

relating to the care of this unique patient population.3) Enable attendees to present challenging pediatric and

adult cases for group discussion.

Course Directors- Francine BNlei, MD & Robert Rosen, MDKeynote Speaker- Odile Enjolras, M.D.Guest Speakers include Alejandro Berenstein, MD & Pat Burro)ws, MD

MWPCM ~~NYU Post-Graduate Medical School550 First Avenue,New York, N.Y. 10016

*Wnb (212)263-5295 fax: 212-263-5293 http:l/www.med.nyu.edu/cme/

The Department of Pediatrics at Gundersen Lutheran Medical Center in La Crosse, Wisconsin, isseeking a BC/BE Neonatologist to work in our 12 patient NICU/4 patient PICU. There are currentlyfour physicians (one neonatologist, one PNICU physician, one PICU physician, and one generalpediatrician) who cover the PNICU service. Neonatal nurse practitioners help cover call and dohelicopter and ground transports.The Department of Pediatrics has 20 pediatricians, six PNPs, four NNPs, and one PA. Our pediatricsubspecialty areas include hematology/oncology, orthopaedics, asthma/allergy/immunology, oph-thalmology, surgery, neonatology, neurodevelopment, neurology, genetics, gastroenterology, andpediatric ICU. This position can be part time or full-time (preferably with another pediatric specialtysuch as pulmonology or general pediatrics). Gundersen Lutheran Medical Center is the westerncampus of the University of Wisconsin Medical School.Gundersen Lutheran is a large integrated health system where over 400 medical, dental andassociate staff practice together. La Crosse is a city with a metropolitan population of 100,000. Safeneighborhoods, excellent schools, affordable housing, exceptional four season recreationalactivities, and diverse cultural activities converge for a great lifestyle in this family-friendly region.

INTERESTED CANDIDATES SHOULD CONTACT:

We support a safe, healthy and drug-free work environment throughbackground checks and controlled substance screening. EOE/AA

Visit our website: www.gundluth.org

June 11-14, 2003 * The Cloister * Sea Island, GeorgiaFranlc P. Bowyer, III, MD, FAAP, Program Chair

Sponsored byGeorgia Chapter * American Academy of Pediatrics

For information contact Nefertiti Yungai * (404) 881-5091 * Fax (404) 249-9503nyungaiOnag.org, or visit our Web site at www.gaaap.org

Private Practicer ~OpportunitySoutheastern Indiana

Full or part-time position available in Batesville, Indiana,with a dynamic group of 5 pediatricians and 3 PNPs, in apractice owned by Cincinnati Children's Hospital MedicalCenter. As a physician in the Division of General &Community Pediatrics, you will receive excellent medicalcenter benefits while practicing small-town medicine. Ifdesired, research opportunities are available.

Batessville, IN, home of a Fortune 500 company, is a uniquetown, offering excellent quality of life., exceptional schools,and an easy drive to Cincinnati.

To ApplyFax your CV to 812-933-0921, attn. Dr. Beischel or Dr. Kelley,or call 1-866-933-0997.

SkCincinnati Visit our website at wwwAncinnatichildrens.orgChildren's Cincinnati Children's Hospital Medical Center is an

4| itMo|edtaeCens Affirmative Action/Equal Opportunity Institution.Women and minorities are encouraged to apply.

Dr. Richard Strauss, ChairDepartment of PediatricsGundersen Lutheran1910 South AvenueLa Crosse, WI 54601800-362-9567 Ext. 52809rstrauss@gundluth.org

Gale KreibichMedical Staff Development

OR Gundersen Lutheran1910 South AvenueLa Crosse, WI 54601800-362-9567 Ext. 56863gkreibicO@gundluth.org

190 AAPNews www.aapnews-org April2003

-I 1 404_ 4%

i ( 0) .

The 26th INTERNATIONAL CONFERENCEON PEDIATRIC/ADULT ALLERGY ANDCLINICAL IMMUNOLOGY, to be held atthe Four Season's Hotel, Toronto, Ontario,Canada, July 18-20, 2003. Sponsored by:SUNYAB, 15 hours, Category I, AMA andAAFP credit. Contact Michele Bauer:Phone: (716) 878-7105; Fax: (716) 888-3841 or E-mail: mbauer?upa.chob.edu.

ZITHROMA(azithromycin for oral suspension)

BRIEF SUMMARYINDICATInONS AND USAGE

ZITHROMAX" (azithromecin) is indicated for the treatment of patients with mild to moderate infections(pneumonia: see WARININGS) caused by susceptible strains of the designated microorganisms in the specificconditions listed below. As recommended dosaaes. durations of theraov. and aoolicable oatient ooDulations varvamong these infections. please see DOSAGE AND ADMINISTRATION for wreific dosing recornmendations.-

Acute otiitis media caused by Haemophilus influenzae, Moraxella catarnhalis, or Streptococcuspneumoniae.(For specific dosage recommendation, see DOSAGE AND ADMINISTRATION.)

Community-acquired pneumonia due to Chlamydia pneumoniae, Haemophilus influenzae,Mycoplasma pneumoniae or Streptococcus pn7eumonmae in patients appropriate for oral therapy. (For specificdosage recommendation, see DOSAGE AND ADMINISTRATION.)

NOTE. Azithmromcin should not be used in pediatric patients with pneumonia mwho are judged tobe inappropriate for oral therapy because of moderate to severe illness or risk factomssuch as any of the following: patients with cystic fibrosis, patients with nosocomiallyacuired infections, patients with known or suspected bacteremia, patients requiring

hospitalization, or patients with significant undeirlying health problems that maycompromise their ability to respond to their illness (including immunodeficiency orfunctional asplenia).

PharyngWs/lonsillitis caused by Streptococcuspyogenesas an alternative to first-line therapy inindividuais who cannot use first-line therapy. (For specific dosage recommendation, see DOSAGE ANDADMINISTRATION.)

NOTE: Penicillin by the intramuscular route is the usual druq of choice in the treatment of Streptococcuspyogenes infection and the prophylaxis of rheumatic fever. ZITHROMAX° is often effective in the eradication ofsusceptible strains of Streptococcuspyoaenesfrom the nasopharynx. Because some strains are resistanttoZITHROMAX°, susceptibilitvtests shou7lfbe performed when patients are treated with ZITHROMAX". Dataestablishing efficacy of azithromycin in subsequent prevention of rheumatic fever are not available.

Appropriate culture and susceptibility tests should be performed before treatment to determine the causativeorganism and its susceptibilit to azithromycin. Therapy with ZITHROMAX" may be initiated before results ofthese tests are knowvn; once%te results become avai a le, antimicrobial therapy should be adjusted accordingly.

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

WARNINGSSerious allergic reactions, including gnioederna, anaphylaxis, and dermatologic reactions including StevensJohnson Syndrome and toxic epidermaT necrolysis have ben reported rarely in patients on azithromycin therapy.Although rare, fatalities have been reported. (See CONTRAINDICATIONS.) Despite initially successfulsymptomatic treatment of the allergic symptoms, when symptomatic therapy was discontinued, the allergicsymptoms recurred soon thereafter in some patients without further azithromycin exposure. Thesepatients required prolongedl periods of observation and symptomatic treatment. The relationship of theseepisodes to the long tissue half-life of azithromycin and subsequent prolonged exposure to antigen is unknown atpresent.

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 therapy isdiscontinued.

In the treatment ofpneumonia, akzithromycin has oniy been shown to be safe and effective in thetreatmnt of community-acquired pneumonia due to Chilamydiapneumnonis, Henphilusinfluenzse, Mlycoplasme pneumoniae, or Sc c u nuoisin patients amppropriate for oral!herapy. Azithrmnycin should not be used inpten ihpemna who are judged to beinapmpnorate for oral therapy because of moeaet eeeilesor risk factors such as any ofthe fllowing: patiernts with cystic fibrosis, patiernts with nosocomially acquired infections, patentwith known Or suspected bacteremia, patients requiring ---pitalization, elderly or debilitatedpatiernts, or patients wit signffcant unrderlying health prolm s that may compromise their ability tores.pond to their illness (icluding immunodeficiency orfhntin el asplenia).

Pseudonmembranous clitis has been reported with nearl l antibacterial agents and may rangeinseeritfrommild t hiefreatenin' Therefore, it is inmportant to consider this diagnosis inpatintswhopresnt ithdiarrhea su'bsequent to the administration of antibacterial agents

Treamenwih atibcteialagents alters the normal flora of the colon and may permit overgrowth ofclostridia. Studies indicate thta 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 beinitiated. Mild cases 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, proteinsupplementation, and treatrnent with an antibacterial drug clinically effective against Clostridium difficilecolitis.

PRECAUTONSGeneral: Because azithromycin is principally eliminated via the liver, caution should be exercised vvhenazithromycin is administered to patients with impaired hepatic furnction.

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 been reported with macrolide products: ventricular arrhythmias, includingventricular tachycardia and torsades de pointes, in individuals with prolonged OT intervals.

There has been a spontaneous report trom the post-marketing experience of a patient with previous histor ofarrhythmias who experienced torsades de,oointesand subsequent myocardial infarction followving a course of7azithromycnteayInfonnation for Patients: ZithromaeP oral suspension can be taken with or without food.

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

azThromycientsimultaneodirecte to discontinue azithromycin immediately and contact a physician if any signs of

DnInScbior: Aluinum-and magnesium-contairirig antacids reduce the peak serum conr,entrations (rate) but

absorption.Azithromycin did not affect the plasma concentrations or pharmacokinetics of theophylline administered as asinlentrvenus ose Th efectof azithromycin on the plasma concentrations or pharrnacokinetics oftheohylineadmnistredin ultpledoses resuiting in therapeutiic steady-state concentrations of theophylline isnotnow.Hoeve, cncurentuseof macrolides and theophylline has been associated with increases in the

serum concentrations of theophylline. Therefore, until further data are available, prudent medical practicedictates careful monitoring of plasma theophylline concentrations in patients receiving azithromycin andAzephlline concomitanti

Aztromiycin did not affct the prothrombin time response to a single dose of warfarin. However, prudentmedical practice dictates careful monitoring of prothrombin time in al patients treated with azithromycin andwarfarin concomitantly. Concurrent use of macrolides and warfarin in clinical practice has been associated withincreased anticoaqulant effects.

The following drug interactions have not been reported in clinical trials with azithromycin, however, nospecific drug interaction studies have been performed to evaluate potential drug-drug interaction. Norietheless,they have been observed with macrolide products. Until further data are developed regarding drug interactionswhen azithromycin and these drugs are used concomitantly, careful monitofing of patients is advised:

Digoin-eevatd dioxinconcntrations.Ergtamne r dhydoerotaine-acute ergot toxicity characterized by severe peripheral vasospasm and

Triaola-dereae te cearnce 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, ana phntin concertruatons.

laboryto Test Irntrrwions: Theryetaare no reported laboratory test interactions.Camcinogenesis, Mutagenesis, Impainnent of Fwtlitqr Long-term studies in animals have not beenperformed to evaluate carcinogenic potential. Azithromycin has shown no mutagenic potential in standardlbrtrtet:mouse lymphoma assay, human lyrnphocyte clastogenic assay, and mouse bone marrowclasogeicssayNo vidnceof impaired fertility due to azithromycin was found.

Preganc.Tratgeni Efect. Pegnncy Cat7«ory B: Reproduction studies have been performed in rats andmiceatdsesup t modratly maealy toxic dose concentrations (i.e., 200 mg/kg/dayl. 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 animalstudies, no evidence of harm to the fetus due to azithromycin was found. There are, however, no adequate andwell-controlled studies in pregnant women. Because animal reproduction studies are not always predictive ofhuman response, azithromycin should be used during pregnancy only if clearly needed.NUrsM Mohrs: It is not knowYn whether azithromycin is excreted in human milk. Because many drugs areexcretecT in human milk, caution should be exercised when azithromycin is administered to a nursing woman.Pediatric Use: (See INDICATIONS AND USAGE AND DOSAGE AND ADMINISTRATION.)

Acute Otitis Media (total dosage regimen: 30mq/kg, see DOSAGE AND ADMINISTRATION): 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):Safety and effectiveness in the treatment of children with community-acquired pneumonia under 6 months ofage have not been established. Safety and effectiveness for pneumonia due toChlamydia pneumoniae andMycoplasma pneumoniae were documented in pediatric clinical trials. Safety and effectiveness for pneumoniadue to Haemophilus influenzaeand Streptococcuspneumoniaewere not documented bacteriologically in thepediatric cli.nical trial due to difficulty in obtaining specimens. Use of azithromycin for these twYomiCrOOrganiSmS iS supported, howvever, by evidence trom adequate andwell-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 oT age have not been established.

Studies evaluating the use of repeate coure of thern have not been conducted.Geriatriic Use: Pharmacokinetic parameters in older voluntee?rsa(V55 wears old) were similar to those inyounger volunteers(118-40 years old) for the 5-davytherapeutic regimen. Dosage adjustment does not appear tobe necessary for older patients with normal renal and hepatic furnction 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 upondiscontinuationl of the drug. Potentially serious side effects of angioedema and cholestatic jaundice werereported rarely. Approximately 0.7% oT the patients (adults and chiildren) from the 5-day multiple-dose clinicaltrials discontinued ZITHROMAX" (azithromycin) therapy because of treatment-related sid effects. In clinicaltrials in children given 30 mg/kg, either as a single dose or over 3 days, discontinuation from the trials due totreatment-related side effects was approximately 1%. (See DOSAGE AND ADMINISTRAlON.) Most of theside effects leading to discontinuation were related to the gastrointestinal tract, e.g., nausea, vomiting, diarrhea,or abdominal pain.Clinical:Children: Single andMultiple-dose regimens, The types of side effects in children were comparable to thoseseen in adults, with different incidence rates for the closage regimens recommended in children.Acute Otitis Media: For the recommended total dosage regimen of 30 mg/kg, the most frequent side effects(21 %) attributed to treatment were diarrhea, abdominal pain, vomiting, nausea and rash. (See DOSAGE ANDADMINISTRATION.) The incidence, based on dosing regimen, is described in the table below:

Dosage Diarrhea, % Abdominal Vomiting,% Nausea, % Rash, %Regimen Pain, %1-da 4.3% 1.4% 4.9% 1.0% 1.0%3-day 2.6% 1.7% 2.3% 0.4% 0.6%5-day 1.8Y% 1.2% 1.1% 0.5% 0.4%

CommunityAcquired Pneumonia: For the recommended dosage regimen ofl10mg/kgon Dayl1followed by 5mg/k onays2-5,the ostfreqentside effects attributed to treatment were diarrhea/loose stools (5.8%),abdoinapan, omiing an nasea(1.9%/ each), and rash 11.6%).

Phayngti/tosilits: or herecommended dosage regimen of 12 ma/k onDy -5, the most frequentrshd effects attribueadahto traten were diarrhea (5.4%), vomiting 15.69%), abdominal pain 13.4%), nausea 12%),

With any of the treatment regimens, no other treatment-related side effects oocurred in children treated withZITHROMAXO with a frequency greater than 1%. Side effects that occurred with a frequency of 1% or lessinicluded the following:Cardiovascular Chest pain.Gastrointestinal: Dyspepsia, constipation, anorexia, enteritis, flatulence, gastritis, jaundice, loose stools andoral moniliasis.Heaoo icnd Lymphatic: Anemia and leukopenia.Nrosjse:Headache (otitis media dosage), hyperkinesia, dizziness, agitation, nervousness and insomnia.

GnrlFee,fce edema, fatigue, fungal infection, malaise and pain.Allerpic: Rash and allergic reaction.ReprtoyCugh increased, pharyngitis, pleural effusion and rhinitis.SknadApndages: Eczema, fungal dermatitis, pruritus, swveating, urticaria and vesiculobullous rash.

SpcaessConjunctivitis.PotMreiaExperience: Adverse events reported with azithromycin during the post-marketing period in

adult and/or pediatric patients for which a causal relationship may not ue established include:AllerOmc Arthralgia, edema, urticaria and angioedema.Cardiovascular Arrhyhmiais including ventricular tachycardia and hypotension.Gastrointsia: Anorexia, constipation, dyspepsia, flatulence, vomiting/diarrhea rarely resulting indehydration, pseudomembranous colitis, pancreatitis, oral candidiasis and rare reports of tongue discoloration.General: Asthenia, paresthesia, fatigue, malaise and anaphylaxis (rarely fatal).Genitourinary: Interstitial nephritis and acute renal failure and vaginitis.Hematopoistic: Thrombocytopenia.Liver/Biliary: Abnormal liver function includina hepatitis and cholestatic jaundice, as well as rare cases ofhepatic necrosis and hepatic failure, some of which have resulted in death.Nervous System: Convulsions, dizziness/vertigo, headache, somnolence, hyperactivity, nervousness, agitationand syncope.Psyhistric: Aggressive reaction and anxiety

Sbn/Dpedags: rurius,rarly erius slin reactions including erythema multiforme, Stevens-Johnson

Specalenss: earig dstubanes ncluding hearing loss, deafness and/or tinnitus and rare reports of tasteperversion.Laboratory Abnormalities:Children:One, Three and Five Dav RegimnLaboratory data collected trom comparative clinical trials emploin two 3-day regimens (30 mg/kg or 60 mg/kgin divided doses over 3days), or two 5-day regimens (30m;glgor60m/gidvdedosoer5ay)wesimilar for regimens of azithromycin and aill comparators combined, with most clinically significant laboratoryabnormalities occurring at incidences of 1-5%. Laboratory data for patients receiving 30 mg/kg as a single dosewere collected in one single center trial. In that trial, an absolute neutrophil count between 500-1500 cells/mm3was observed in 10/64 patients receiving 30 mg/kg as a single dose, 9/62 patients receivinq 3 mg/kg qivenover 3 days, and 8/63 comparator patients. No patient had an absolute neutrophil count <50 cells/mm3 (SeeDOSAGESAND ADMINIIT lON )In multiple-dose clinical tfials involving appoimtly 4700 pediatric patients, no patients discontinued therapybecause of treatment-related laborator abomltes.

DOSAGE AND AMNISTRATION (See INDICATIONS AND USAGE.)Zithromaxl for oral suspension can be taken with or without food.Acute Otitis Media: the recommended dose of ZITHROMA)C for oral suspension for the treatrnent of childrenwith acute otitis media is 30 mg/kg given as a single dose or 10 mg/aoc al o 3 days or 10 mq/kg as asingle dose on the first day followed by 5 mg/kg/day on Days 2 throuh5 h aeyo re-dosinq azithromycin inchi[dren who vomit after receiving 30 mg/kg. as a single dose has not benetb ishdn clinical?studiesinvolving 487 patients with acute otitis medTia qiven a single 30 mg/kg dose of azithromycin, eight patients whovomited-within 30 minutes of dosing were re-dosed at the same total dose.Communitv-Acquired Pneumonia: The recommended dose of ZITHROMAX" for oral suspension for thetreatment 6of children with community-acquired pneumonia is 10 mg/kg as a single dose on the first day followedby 5 mgk n Days 2 huh5.Phrynitis/Tonsiillitis: Nh eommended dose of ZITHROMAXI for children with pharyngitis/tonsillitis is12 mg/kg once daily for 5 days.Formore detailedprr7duct information please refer to the fullprescribing informnaton or call 1 8008793477.

Rev.9 January 2002

NEW YORK - I am a Pediatrician looking forfull time clinic/practice setting in the New YorkCity area. Please call Susan at (212) 717-9505.

SOUTHEASTCentral Kentucky. BE/BC Pediatrician needed.Small rural town in Central Kentucky, low-income population. Location: Lebanon, KY.Responsibilities include: examine, diagnoseand treat patients from birth to adolescent;inpatient and outpatient duties; attend C-Section and complicated deliveries; and sharecalls 1:2. Qualified applicant must have MDdiploma, three years U.S. Pediatric residencytraining, eligible for Kentucky State Medicallicense and presently at the time of applicationhave and hold the legal authority to work inthe U.S. No Jl/Hl. Please mail your CV to:Office Manager, 429 W. Walnut St., Lebanon,KY 40033.

ENERGETIC BC1BE PEDIATRICIAN WANTED tojoin dynamic academically-oriented nationallyrespected practice in Dade, Broward and PalmBeach County, Florida. Immediate openings inour Palm Beach locations. Unparalleled lifestylefor primary care pediatrician with exceptionalsalary and benefits. Reply to: PediatricAssociates, PA4620 North State Rd., 7 Ste. 316,Lauderdale Lakes, FL 33319, Attention: PeterShulman, M.D., Physician Recruiffng, or fax acurrent CV to: (954) 967-6410.

MIDWESTLarge primary care group in Central NJ seekingfull-time and part-time B/C or B/E GraduatePediatnican to join busy established practice. Musthave NJ medical license. Competitve salary andbenefits. E-mail CV to: dianebprngOyahoo.comor fax to (908) 222-3709.

SOUTHWESTPediatric Cardiology group seeks a third physi-cian to join a rapidly growing private practicewith university affiliation in Las Vegas, Nevada.This is a young progressive practice in America'sfastest growing city with opportunity for earlypartnership. ContactTom Johnson, M.D.: (702)366-1 100; TJOHNLV@yahoo.com.

NORTHWESTRural Washington State Opportunity-Seeking BC/BE pediatrician(s) to join our prac-tice in a scenic agricultural community inCentral Washington State. We are part of amulti-specialty, (peds, IM, FP, OB, surgery)non-profit, community clinic committed to pro-viding medical care to Hispanic laborers andtheir families as well as other underservedgroups within this ethnically diverse commu-nity. Family oriented community offers reward-ing lifestyle and abundant recreational activi-ties. This is a salaried position with excellentbenefits and malpractice coverage. Pediatricianduties include clinic and hospital work withcall. Good support from'tertiary care centers inSeattle. Loan repayment possible. Spanish lan-guage skills are useful. EOE. Reply to: YVFWC,HR Department, P.O. Box 190, Toppenish, WA98948 or call: (509) 865-6175, ext. 2284, fax:(509) 865-2891; e-mail: markrOyvfwc.org.

MONTANA. You've Earned It. Things aredifferent here. We have the technology andpersonnel to help your practice grow andpatients who need and appreciate your skills.The Great Falls Clinic is seeking aPediatrician to join a 12-member PediatricDepartment in a rapidly expanding 100+provider, multi-specialty organization. Weoffer a benefit package and salary leading topartnership. If interested, send CV and pro-fessional goals to: Jeff Hinz, M.D., Medical

-1----

ogist, and broad base of subspecialtyproviders and surgeons. Great Falls is a fam-ily-friendly community with excellentschools, low crime, clean air, and a reason-able cost of living. In addition, you will haveaccess to world-class recreational venues,outdoor activities, scenic vistas and regionalculture right outside your practice door.Qualified candidates will have excellent clin-ical and interpersonal skills, be a team playerand enjoy working closely with families andother physicians. The Great Falls Clinic offersa competitive benefit package and salaryleading to partnership. If interested, send CVand professional goals to: Jeff Hinz, M.D.,Medical Director, P.O. Box 5012, Great Falls,

MT 59403. E-mail: jeff.hinzAgfclinic.com orcheck out our Web site at www.gfclinic.com.

Director, P.O. Box 5012, Great Falls, MT59403. E-mail: jeff.hinzEgfclinic.com; Website: www.gfclinic.com.

BIG Opportunity Under Montana's Big SkyThe Great Falls Clinic is looking for a BC/BENeonatologist interested in joining theNeonatology department of a 100+ provider,multi-specialty organization. This positionwill provide the right candidate with theunique opportunity to work in a progressivelevel 3 nursery engaged in multidisciplinarycare, tackle challenging neonatal cases, workwith conventional/high frequency ventila-tion and nitric oxide therapy and collabo-rate with a nationally-recognized perinatol-

Augmerntin lamoxicillin/clavulanate potassium) is a registered trademark of GlaxoSmithKline.Referenoes: 1. Data on file. Pfizer Inc., New York, NY.L Block SL, Arrieta A, Seibel M, McLinn S, Eppes SC. Single dose azithromycin (30 mg/kg) in acute Mfts media. Paper presented at IDSA 38th Annual Meeting;September7-10, 2000; New Orleans, La. Abstract 174.

asb uLs PhamceuticalZX120881 (B 2002 Pfizer Inc. All rights reserved.

April2003 www.aapnews.org AAPNews 191

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