NEVV FELLOVVSDear 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

list. In submifting 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.

New York 1

Richard Alling, M.D., FAAPCanandaigua, NY 14424-1728

Uzma Mehr, M.D., FAAPHornell, NY 14843-1003

Philip Rem'llard, M.D., FAAPLiverpool, NY 13090

Sania Wilkins, D.O., FAAPSyracuse, NY 13224

New York 2

Adeola Ayodeji, M.D., FAAPCarmel, NY 10512-5004

Deborah Brant-Deitch,M.D., FAAPRoslyn, NY 11576-1506

Joseph Cohen, M.D., FAAPBrooklyn, NY 11235-2301

Amy Goldberg, M.D., FAAPNew York, NY 1001 6

Mahmoud Hassanein,M.D., FAAPBrooklyn, NY 11209-6810

Erik Langenau, D'O., FAAPBrooklyn, NY 11234-4501

Tracy Lee, M.D., FAAPMineola, NY 11501-2302

Philip Pasternak, M.D., FAAPBronx, NY 10463-1246

Joni Scheidt, M.D., FAAPForest Hills, NY 1 1 375-5106

Syrgery Specialty FellowK-1chard Scriven, M.D., FAAPStony Brook, NY 1 1 794

Neurology Specialty FellowAkila Venkataraman,M.D., FAAPBrooklyn, NY 1 1 220-2429

Jason Wu, M.D., Ph.D., FAAPBrooklyn, NY .1 120-4233

Peywen Wu, M.D., FAAPRoslyn, NY 1 1 576

New York 3

Janeene Gordon, M.D., FAAPSloatsburg, NY 10974-1613

Seth Ness, M.D., FAAPNew York, NY 10029-7219

Vicki Porges, M.D., FAAPNew York, NY 1001 6

Andrew Satran, M.D., FAAPPomona, NY 10970

MarylandSha Avhree Buckman,M.D., FAAPWheaton, MD 20902

Gayle Fischer, M.D., FAAPBethesda, MD 20814-4235

Sanjay Jain, M.D., FAAPBaltimore, MD 21210

Kassandra Merker, M.D., FAAPGaithersburg, MD 20878-2263

Julie Yeh, M.D., FAAPBaltimore, MD 21209-4203

New JerseyAlison Cessario, M.D., FAAPSummit, NJ 07901-2571

Abdulla Al-Kaabi, M.D., FAAPDohaQatar

Girish Chandrashekharaiah,M.B.B.S., FAAPBangalore Karnataka 560076India

Andrew Kiboneka, M.D., FAAPKampalaUgandaStephane Paulus, M.D., FAAPBlantyre 3Malawi

Waltraud Saftler-Ertl,M.D., FAAPVienna Al 060Austria

Connecticut

Gretchen Crist, M.D., FAAPGreenwich, CT 06831

Errol Douglas, M.D., FAAPHartford, CT 06105-1210

Jonathan Sollinger, M.D., FAAPWestport, CT 06880

Maine

Stephen Donnelly, D.O., FAAPScarboro.ugh, ME 04074-9031

Kimberly MacDonald,M.D., FAAPFreeport, ME 04032-1305

Massachusefts

Kerri Benneft, M.D., FAAPNorth Andover, MA 01 845

Matthew Benz, M.D., FAAPSouthboro, MA 01 772

Michael Eikort, M.D., FAAPNewton, MA 02462

Michelle Jones, M.D., FAAPSwampscoft, MA 01 907

Laura Koweek, M.D., FAAPBoston, MA 02116

Nina Sand, M.D., FAAPNewton, MA 02458-1326

Uniformed Services-East

Pamela Limb, M.D., FAAPNew Bern, NC 28562

Erich Maul, D.O., FAAPBiloxi, MS 39531-6134

James Rick, M.D., FAAPOcean Springs, MS39564-5936-

Sarah Ryan, M.D., FAAPJacksonville, NC 28546

Joel Shulkin, M.D., FAAPAPO, AE 09137-0200

Scott Stuart, M.D., FAAPGoosecreek, SC 29445

Vermont

Stephen Reville, M.D., FAAPSpringfield, VT 05156

Susan Scoft, M.D., FAAPEssex Junction, VT 05452-3945

Arvin Garg, M.D., FAAPPlainsboro, NJ 08536-3608

Bruce Grossman, M.D., FAAPMorris Plains, NJ 07950-3333

6aurang Patel, M.D., FAAPAvenel, NJ 07001-1048

Christine Sheehan, D.O., FAAPHaddonfield, NJ 08033-2641

PennsylvaniaAnne Ades, M.D., FAAPPhiladelphia, PA 19118-3417

Brian Alverson, M.D., FAAPPhiladelphia, PA 19103-5957

Song-Ok Chin, M.D., FAAPPlymouth Meeting, PA 19462

Orthopaedics Specialty FellowTheociore Ganley, M.D., FAAPPhiladelphia, PA 19104

John Gorlowski, M.D., FAAPSt. Marys, PA 15857-3483

Samir Henien, M.D., FAAPCnr+^n DA 4QnA')-GrfIf)

Thomas Bruns, M.D., FAAPChattanooga, TN 37421-6307

Bradley Carter, M.D., FAAPMemphis, TN 38122-4643

Jason C eney, M.D., FAAPOak Ri ge, TN 37830

Deborah Fernandes,M.D., FAAPDyersburg, TN 38024-6537

Scoft Guthrie, M.D., FAAPHendersonville, TN 37075

Kelly Kriwanek, M.D., FAAPMemphis, TN 38135-0298

Michele Spring, M.D., FAAPNashville, TN 37232-2581

Natascha Thompson,M.D., FAAPCardova, TN 38018-3500

VirginiaCharlofte Collin, M.D., FAAPNorfolk, VA 23502-5260

Indiana

Laura Gaffney, M.D., FAAPIndianapolis, IN 46208

Jeffrey Gatz, M.D., FAAPValparaiso, IN 46383-3277

Brandy Kashyap, M.D., FAAPIndianapolis, IN 46202-4663

Rhoda Yueh, M.D., FAAPIndianapolis, IN 46254-9630

MichiganJudy Black, M.D., FAAPNiles, MI 49120-4083

Amy Cooke, M.D., FAAPAnn Arbor, MI 48103-91 11

Francis Darr, M.D., FAAPCheboygan, MI 49721-9430

Ohio

Yilin Chang, M.D., FAAPFindfay-, OH 45840-5015

Bradley Dixon, M.D., FAAPCincinnati, OH 45209-1840

Katherine Krueck, M.D., FAAPWesterville, OH 43082

Ophthalmology SpecialtyFellowArysol Niffenegger, M.D., FAAPMassillon, OH 44646

Carrie Reed, M.D., FAAPTailmadge, OH 44278

Eriks Usis, M.D., FAAPMentor, OH 44060

Robert Wallace, M.D., FAAPLoveland, OH 45140

: Ontario

: Christine Ricks, M.D., FAAP: Toronto, ON M4V 2L7: Canada

Surgery Specialty FellowOluyinka Olutoye,M.D., Ph.D., FAAPHouston, TX 77030-2399

Christina Purnell, M.D., FAAPCorpus Christi, TX 78411

Antonio Rodriquez, M.D., FAAPLaredo, TX 78045-6304

Michelle Saenz, M.D., FAAPAustin, TX 78746

Susan Smart, M.D., FAAPRockwall, TX 75032-5856

Tammi Williams, M.D., FAAPIrving, TX 75061

Francis Kangethe, M.D., FAAPMatteson, IL 60443-2076

Elizabeth Kramer, M.D., FAAPMorton, IL 61550

Ramzan Shahid, M.D., FAAPMokena, IL 60448-8383

Kathleen Webster, M.D., FAAPOak Park, IL 60304-2020

Iowa

Michelle Miller, M.D., FAAPIowa City, IA 52246-8632

Sara Stover, M.D., FAAPIowa City, IA 52246

Kansas

Kelly Kreisler, M.D., FAAPOverland Park, KS 66209-3716

Chris Stone, M.D., FAAPWichita, KS 67220

Missouri

Michelle Beumer, M.D., FAAPUnion, MO 63084

Jennifer Hulsen, M.D., FAAPSt Louis, MO 63122-2027

Nikoleta Kolovos, M.D., FAAPSt Louis, MO 63130-4026

Fiona Levy, M.D., FAAPSt Louis, MO 631 1 0

Alan Skouitchi, M.D., FAAPSt Louis, MO 63017

Christopher Wilson,M.D., FAAPSt. Louis, MO 63126-3702

Alabama

Surgery Specialty FellowMichael Fuenfer, M.D., FAAPMobile, AL 36607

Elizabeth Peters, M.D., FAAPBirmingham, AL 35235

Jeffrey Tamburin, M.D., FAAPDothan, AL 36305-6919

Arkansas

Richard Reinhard, M.D., FAAPJonesboro, AR 72401

Louisiana

Marlene Broussard, M.D., FAAPShreveport, LA 71118-2021

Brandi Jones, M.D., FAAPNew Orleans, LA 70130-1759

MississippiWilliam Barreft, M.D., FAAPOlive Branch, MS 38654

Texas

Lynae Canales, M.D., FAAPCorpus Christi, TX 7841 1Surge7S cialty Fellow

.peDarre ass, M.D., FAAPHouston, TX 77030-2399

Adeinery Gonzalez, M.D., FAAPSan Antonio, TX 78216-7731

Cheryl Landry, M.D., FAAPLubbock, TX 79423-2926

Kirsten Lentsch, M.D., FAAPRichmond, TX 77469-6112

Kimberly Mehendale,M.D., FAAPDallas, TX 75209-5701

Alaska

Alice Antonescu, M.D., FAAPFairbanks, AK 99709

Eric Noble, M.D., FAAPAnchorage, AK 99507

Arizona

Susan Chung, M.D., FAAPPhoenix, AZ 85020

Jose Fierro Cueto, M.D., FAAPPhoenix, AZ 85018-5438

Kimberly Gerhart, M.D., FAAPPrescoft, AZ 86301

John Hartley, D.O., FAAPPhoenix, AZ 85014-2008

Surgery Specialty FellowDavid Notrica, M.D., FAAPPhoenix, AZ 85006

Colorado

Larry Mafthews, M.D., FAAPLiftleton, CO 80123-2944

Nevada

Daniel Colombo, M.D., FAAPLas Vegas, NV 89145-8850

Shane Rostermundt,D.O., FAAPHenderson, NV 89052

New Mexico

Lisa Jimenez, M.D., FAAPAlbuquerque, NM 87120-4811

Meredith Reynolds,M.D., FAAPRoswell, NM 88201

OregonJeannine Johnson, M.D., FAAPPortland, OR 97229-3685

Scoft Shipman,M.D., M.P.H., FAAPWest Linn, OR 97068

Uniformed Services-West

Amy Belisle, M.D., FAAPApo, AP 96326-7000

Cheryl Okado, M.D., FAAPFPO, AP 96362-0199

Utah

Dale Gerstmann, M.D., FAAPProvo, UT 84604

Shannon Staker, M.D., FAAPRoosevelt, UT 84066

WashingtonJennie Austin, M.D., FAAPMoses Lake, WA 98837

tasion, rA'itsu4z--!oDuu

Ann Roberts, M.D., FAAPPhiladelphia, PA 19107-6021

KentuckyMichelle Bennett, M.D., FAAPLexington, KY 40507-1130

Harohalli Shashidhar,M.D., FAAPLexington, KY 40356-0284

Michelle Sumrall, M.D., FAAPElizabethtown, KY 42701

Massachusetts

Karen A. DeMuth, M.D., FAAPWestwood, MA 02090

North Carolina

Jonathan Brownlee,M.D., FAAPShelby, NC 28150-4718

Dean Cauley, M.D., FAAPElizabeth City, NC 27909

Christina Fi&lozzi, M.D., FAAPWinston Salem, NC27127-5772

Frederick Heweft, M.D., FAAPRaleigh, NC 27614

Ashokkumar Jain, M.D., FAAPFayetteville, NC 28311-2968

Eric Jones, M.D., FAAPCary, NC 27511-8926

Sharmila Jones, M.D., FAAPCary, NC 27511

Vivian Makar, M.D., FAAPDurham, NC 27713

Nicole Safina, M.D., FAAPJacksonville, NC 28546-7043

Frini Shah, M.D., FAAPDurham, NC 27713-9455

South Carolina

Zenaida Candela, M.D., FAAPBenneftsville, SC 29512-2667

Tennessee

Jennifer Amrol, M.D., FAAPNashville, TN 37221-3300

Paul Barongan, M.D., FAAPClinton, TN 37716-2423

p01 P2 9 N tooM

Illinois

Jennifer Blount, M.D., FAAPWheaton, IL 60187

Jeffrey Cabotaje, M.D., FAAPChicago, IL 60614-1758

Youn Hong, M.D., FAAPChicago, IL 60618-7818

278 AAP News wwwaapnewsorg June 2003

N EVV F EL LOVWVS

.qq

Troy Jacobs,M.D., M.P.H., FAAPSeattle, WA 98122-0874

James O'Callaghan,M.D., FAAPSeattle, WA 98103

California 1

Stephanie Grayson, M.D., FAAPPalo Alto, CA 94301-2548

California 2

Alexandra Clark, M.D., FAAPLoma Linda, CA 92313

Lori Kandel, M.D., FAAPLos Angeles, CA 90036

Passara Liangthanasarn,M.D., FAAPLong Beach, CA 90806-1646

Annica Lin, M.D., FAAPLos Angeles, CA 90049-7900

Lisa Paquette, M.D., FAAPPasadena, CA 91 105-1329

California 3

Annie Kupelian, M.D., FAAPLaJolla, CA 92037

*California 4

Blake Alban, M.D., FAAP*Los Alamitos, CA 90720

Plastic Surgery Specialty Fell*Michael Sundine, M.D., FAA*Orange,CA92868

Mai-Khanh Tran, M.D., FAA*Fountain Valley, CA 92708

:Gilbert Umnas, M.D..Orange,CA92869

.Alabama

*Eva Allen, M.D., FAAP*Birmingham, AL 35208-341!

*Grant Allen, M.D.,FAAP.Florence, AL 35630

*Florida

*Briggs Carroll, M.D., FAAP*Sarasota, FL 34232-6620

*Shelley Collins, M.D., FAAP*Miami, FL 33129-2306

Margoth Diaz, M.D., FAAP*Miami, FL 33179-2425

I/owkp

.p

5

:Rogerio Faillace, M.D., FAAP*Lighthouse Point, FL 33064

Philip Floyd, M.D., FAAP*Coral Gables, FL 33146-1806

*Ophthalmology SpecialtyFellow:Robert Gold, M.D., FAAPLongwood, FL 32750

:Sandra Morris, M.D., FAAP*Plantation, FL 33317

Carlos Mujica, M.D., FAAP*Zephyr Hills, FL 33542

Giovanni Piedimonte,M.D., FAAP*Miami, FL33136

Ronald Rempfer, M.D., FAAP*St Petersburg, FL 33702

:Jeth Salomon, M.D., FAAP.St Petersburg, FL 33710-1647

Marilyn Sprenkle, M.D., FAAPDentin, FL 32541

Tonya Williams, M.D., FAAP*Oviedo, FL 32765-5646

.Georgia

*Terrence Gfroerer, M.D., FAAPDunwoody, GA 30338-3751

:Allison Houck, M.D., FAAP*Cordele, GA 31015-0936

Darryl Morris, M.D., FAAP:Atlanta, GA 30342-1605

Carla Neal-Haley, M.D., FAAP*Mabuton, GA 30126

Javier Tejedor-Sojo, M.D., FAAP.Rome, GA 30165

:Puerto Rico

Norma Arciniegas Medina,:M.D., FAAP*Caborojo, PR 00623

*DISTRICT I

*Eileen M. Ouellette, M.D., J.D.Pediatric Neurology

:North Shore Children's Hospital57 Highland Ave.

*Salem, MA 01970-2197.e-mail: eouelletteOaap.org

DISTRICT II

*Robert M. Corwin, M.D.:Medical Director- MedBest251 Salina Meadows Pkwy.

*Suite 100:Syracuse, NY 13212-4572*e-mail: rcorwinOaap.org

: DISTRICT III

.Alan E. Kohrt, M.D.Medical Director/

:Children's Health NetChildren's Hospital ofPhiladelphia

*34th and Civic Center Blvd.:Philadelphia, PA 19104-4399*e-mail: akohrtOaap.org

DISTRICT IV

:David T. Tayloe, Jr., M.D.2706 Medical Office Place*Goldsboro, NC 27534-9460:e-mail: sewardsWaap.org

*DISTRICT V

:Ellen Buerk, M.D.Oxford Pediatrics5141 Morning Sun Rd.*Oxford, OH 45056-9722*e-mail: ebuerkWaap.org

.DISTRICT VI

:Kathryn Piziali Nichol, M.D.:1314 Morrison St.Madison, WI 53703-3812e-mail: knicholQ?aap.org

:DISTRICT Vll

*Gary Q. Peck, M.D.:Office of Public Health:325 Loyola Avenue - Suite 513New Orleans, LA 701 12-1829

*e-mail: gpeckOaap.org

:DISTRICT Vlill

*Jon R. Almquist, M.D.Virginia Mason Medical Center:Departmentof Pediatrics33501 First Way SouthFederal Way, WA 98003-6208

*e-mail: jalmquist?aap.org

:DISTRICT IX

Burton F. Willis, M.D.:9900 TalbertSuite 201*Fountain Valley, CA92708-51 53

*e-mail: bwillisEaap.org

*DISTRICT X

:Charles Linder, M.D.:Medical College of Georgia1120 15th St..Rm. HF1117:Augusta,GA30912-0004*e-mail: clinderOaap.org

The Potty Pager teaches bedwetters to respond normally to bladder fullness. Ituses a tactile alarm, much like a silent business pager. It is 100% safe, and costs

just $56.00 + S&H. It comes with a 30 day no-questions guarantee.I

June2003 www.aapnews.org AAPNews 279

The 'WIRELESSalarni that wakes

the BEDWETTER...not the whole house!

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

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

oaof~~~~~~~~~~~~~~~~~A**0- AW*

B-OARD REVEW:COURSEXPediatricjWdAine 2003

Cr Cantent - Compre'hensive ReviewNO PASS- NO PAY!!St.t:u 40MO Ot. 12 -1643 AAP, AMA, ACEP. Cat 1,

AAFP,, AOA credits

Tuition: $795:.00X;: ~www.pedi-aticboards.com

1-800-MED-TEST (633-8378)pediaric'boards@aol.comFAX: (314) 416-4600CME REVIEWS INC.

PO Box 510222St. Louis, M'O 63:151-0222

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. N'eonatal 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 1 OOJOOO. Safeneighborhoods, excellent schools, affordable housing, exceptional four season recreationalactivities, and diverse cultural activities converge for a great l'ifestyle 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

u 1L1 1SM ~~~~~~~~sm__~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~---

I~~ az s_zs

_~~~~~~~~~-II

PEDIATRIC GASTROENTEROLOGISTIf you're looking for a healthcare setfing where you can feel personally and. professionally at home, thenGundersen Lutheran is rigt where you belong. Here, you'll find metropolitan-scale medicine, educationand research amid a small town character and comfort. Gundersen Lutheran Medical Center, a 235-bedteaching hospital with a Level II trauma and emergency center, and its 45 medical facilifies serve morethan 500,000 residents in three states. 'Within our multi-specialty group practice, you'll work with morethan 440 medical staff members within a 25-clinic network practicng in the La Crosse, Wlsconsin area.

The Department of Pediatrics at Gundersen Lutheran is seeling a full-fime pediatric gastroenterologist.The GI departfnent has six board-certified adult gastroenterologi.ss and a state-of-the-art GI procedurelab avaiable.The Departinent of Pediatrics has 20 pediatricians, Six PNPs, four NNPs, and one PA. Our pediatricsubspecWaty areas include hematology/oncology, orthopedics, asthmatallergy/hinmunology,ophthalmology, surgery, neonatology, neurodevelopment, neurology, genetics, and pediatric ICU. Thepediatric inpatient service also includes an eight pafient NICU, a four palient PICU, and a 20 pafientpediatrc inpatient service.

We offer an excellent compensation/benefits package, including relocagon expenses and condnuingeducation opportunifies. Interested candidates should contact Gale Krelbich, Medical StafDevelopment, Gundere Luthera, 1910 Sout Ave., La Crosse, WI 54601 at (800) 362-9567, ExL 56863, Emf: gkreibicEgundluth.org or Dr. Richard Strauss, Chlair, Dept. ofPar aics, Gundersen Lutheran, 1836 South Ave., La Crose, WI 54601 at (800) 362-9567,Ex 52809, lEmafl: rAstraussftundluth.org.

ft rwedxtAkw byMam

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

www.gundluth.org

7he Right Carr. Riht Here. A

Lane"~~~~~~J

THIS MONTH8S FEATURED PRODUCT Extensive Produd SeletonBrand Name AlarnsWthes for Tiffed VoidingBedwoffng ResourcesGuaranteed Low PricesFast Deiver

Call or omail us for a 6upplXof catalogs for lour pationt6.

800^ #"A SAO5www.bedwfle.com

_L~~~~~CO C I_

Dr. Richard Strauss, ChairDepartment of PediatricsGunderson Lutheran1910 South AvenueLa Crosse, WI 54601800-362-9567 Ext. 52809rstraussEgundluth.org

Gale KreibichMedical Staff Development

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

280 AAPNews www.aapnews.org June2003

Rght IWhere

¢dwttingdStorvw0T

ZITHROMA)((azithrmnycin for oral suspension)

BRIEF SUMMARYINDICATIONS AND USAGE

ZITHROMAXO (azithromycin) is indicated for the treatment of patients with mild to moderate infections{pneumonia: see WARNINGS) caused bysusceptibe strains of the designated microorganisms in the specificconditions listed below. As recommende dosaaes. durations of theraov. and anolicable Datient pgpulations varyamong these infections. please see DOSAGE AND ADMINISTAINfr specific dosing recomrmendations.~

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

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

NOTE: Azithromycin should not be used in pediatric patients with pneumonia who are judged tobe inapprpopite for oral therapy because of moderate to severe illness or risk factorssluch as any of the following: patients with cystic fibrosis, patients with nosocomiallyhacquired infections, patients with known or suspected bacteremia, patients requiringhospitalization, or paidents with significant underlying health problemts that maycompromise their ability to respond to their illness (including immunodeficiency orfunctional asplenia).

Pharyngitis/tonsillitis caused by Streptococcuspyogenesas an altemative to first-line therapy inindividuals wvho cannot use first-line therapy. (For specific dosage recommendation, see DOSAGE ANDADMINISTRATION.)

NOTE: Penicillin by the intramuscular route is the usual drug of choice in the treatment of Streptococcuspyogenes infection and the prophylaxis of rheumatic fever. ZITHROMAXO is often effective in the eradication ofsusceptible strains of Streptococcuspyogenesfrom the nasopharynx. Because somne strains are resistant toZITHROMAXI, susceptibilit tests should be performed when patients are treated with ZITHROMAXO. 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-y to azithromycin. Therapy with ZITHROMAXI may be initiated before results ofthese tests are known; once tne results become available, antimicrobial therapy should be adjusted accordingly.

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

WARNINGSSerious allergic reactions, including anqioedema, anaphylaxis, and dermatologic reactions including StevensJohnson Syndrome and toxic epidermaT necrolysis have been 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 prolonged periods of observation and symptomatic treatment. The relationship of theseep'sodes 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 tramnt of pneumonia, azithrormycin has only been shown to be safe and effective in thetreatment cof community-acquired pneunmoia due to Chlanrydia pnuwoie Haemophilusinfluenzae, AMycoplarna pneunxoniae, or Srpocusnenni in patients appropriate for oraltherapy. Azithrmywcin should not be used i ateswthpumna who are judged to beinaprpmpnate for oral therapy because of moeaet eeeilesor risk factors such as any ofthe following: patients with cystic fibrosis, pabents with nosocomially acquired infections, patientswith known or suspecited bacteremia, patients requiring hospitalizabon, elderly or debilitatedpatients, or patients wit snificant tinderlying health problemis that may compromise their ability torespond to their illness zinudg immunodeficiency or function al asplenia).

Pseudomembranous cltshsbeen reported with nearly all antibacterial agents and may rangein evriyfommid t lfethratniq.Theretore, it isimportant toconsider this diagnosis inpatintswhopresnt ithdiaffhea subsequent to the administration of antibacterial agents.

Treamenwih atibcteialagents alters the normal flora of the colon and may permit overgrowth ofclostridia. 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 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 treatment with an antibacterial drug clinically effective against Clostridium difficile colitis.

PRECAIJTIONSGeneral: Because azithromycin is principa~lly eliminated via the liver, caution should be exercised whenazithromycin is administered to patients with impaired hepatic function.

There are no data regardingq azithromycin usage in patients with renal impairment, thus, caution should beexerc'sed 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 intefvals.

There has been a spontaneous report trom the post-marketing experience of a patient with previous history ofarrhythmias who experienced torsades de ,oointes and subsequent myocardial infarction following a course otazithromyi therapy.IIIFIIIabUU for Patients: Zithromax* oral suspension can be taken with or without food.

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

The patient should be directed to discontinue azithromycin immediately and contact a physician if any signs ofan allergic reaction occur.Drug Interactions: Aluminum- and magnesium-containirig antacids reduce the peak serum corcentrations (rate) butnot the AUC (extent) of azithromycin absorption.

Administration of cimetidine (800 mg) two hours prior to azithromycin had no effect on azithromycinabsorption.

Azithromycin did not affect the plasma concentrations or pharmacokinetics of theophylline administered as asingle intravenous dose. The effect of azithromycin on the plasma concentrations or pnarmacokinetics oftheophylline administered in multiple doses resuiting in therapeutic steady-state concentrations of theophylline isnot known. However, concurrent use of macrolides and theophylline has been associated with increases in theserum concentrations of theophylline. Therefore, until further data are available, prudent medical practicedictates careful monitoring of plasma theophylline concentrations in patients receiving azithromycin andtheophylline concomitantly

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

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

Digoxin-elevated digoxin concentrations.Ergotamine or dihydroergotamine-acute ergot toxicity characterized by severe peripheral vasospasm anddysesthesia.Triazolam-decrease the clearance of triazolam and thus may increase the pharmacologic effect of triazolam.Drugs metabolized by the cytochrome P450 systemi-elevations of serum carbarnazepirie, terfenadine,cyclosporine, hexobarbital, and phentoin concentrations.LabortoryTeslInteactins Tere are no reported laboratory test interactions.Carcioqensis,Mutaeness, Impairment of Fertility: Long-term studies in animals have not beenperfrmetoevalatecarinoenic potential. Azithromycin has snown no mutagenic potential in standardlabratrytess: oue Impoma assay, human lymphocyte clastogenic assay, and mouse bone marrowclasogeicssayNo vidnceof impaired fertility due to azithromycin was found.

Prenany:eraogeic ffets.Prenancy Category B: Reproduction studies have been performed in rats andmice~~ ~ ~~~atdssu omdeaeymtraly toxic dose concentrations (i.e., 200 mg/kg/day). These doses, based

on a mg/ml basis, are estimated to be 4 and 2 times, respectively, the human daily dose of 500 mg. In the animalstudies, no eviderice 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.Nursing Mothers:lt'isnot knowfnwhether azithromycin is excreted in human milk. Because many drugs areexcreted in human milk caution should be exercised when azithromycin is administered to anursing woman.Pediatric Use: (See INDICATIONS AND USAGE AND DOSAGE AND ADMINISTRATION.)

Acute Otitis Media (total dosage regimen: 30mg/kg, see DOSAGE AND ADMINISTRATION): Safety andeffectiveness in the treatment of children with otitis n;edia 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 influenzae and Streptococcus pneumoniae were not documented bacteriologically in thepediatric clinical trial due to difficulty in obtaining specimens. Use of azithromycin for these twomiCrOOrganiSmS iS supported, however, by evidence from 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 pharyntqitis/tonsiTlitis under 2 years ot age have not been established.

Studies evaluating the use of repeated courses of therap have not been conducted.Geriatric Use: Pharmacokinetic parameters in older voIlinteers (6585 years old) wvere similar to those inyounger volunteers (18B-40 years old) for the 5--day therapeutic regimen. uosage adjustment does not appear tobe necessary for older patients with normal renal and hepatic function receivng 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. Potentially serious side effects of angioederma and cholestatic jaundice werereported rarely. Approximately 0.7% of the patients (adults and children) from the 5-day multiple-dose clinicaltrials discontinued ZITHROMAXO (azithromycin) therapy because of treatment-related side 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 ADMINISTRATION.) Most of theside effects leading to discontinuation were related to the gastrointestinal tract, e.g., nausea, vomiting, diarrhea,or abdominal pain.Clinical:Children: Single and Multiple-dose regimens The types of side effects in children were comparable to thoseseen in adults, with different incidence rates for the dosage regimens recommended in children.Acute Otitis Media: For the recommended total dosage regimen of 30 mg/kg, the most frequent side effects(2 %) 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, %/-n1 -day 4.3% 1.4% 4.9% 1.0% 1.0%3-day 2.6% 1.7% 2.3% 0.4% 0.6%5-day 1.8% 1.2% 1.1% 0.5% 0.4%

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

Pharyngitis/tonsillitis: For the recommended dosage regimen of 12 mq/kg on Days 1-5, the most frequentside effects attributed to treatment were diarrhea (5.4%), vomiting (5.6%), abdominal pain (3.4%), nausea (2%),rash (0.7%), and headache (1.1%).

With an of the treatment regimens, no other treatment-related side effects occurred in children treated withZITHROMAX- with a frequency greater than 1%. Side effects that occurred with a frequency of 1% or lessincluded the following:Cardiovascular. Chest pain.Gastrointestinal: Dyspepsia, constipation, anorexia, enteritis, flatulence, gastritis, jaundice, loose stools andoral moniliasis.Heaooic aind Lymphatic: Anemia and leukopenia.NouSytm: Headache (otitis media dosage), hyperkinesia, dizziness, agitation, nervousness and insomnia.GnrlFee,face edema, fatigue, fungal infection, malaise and pain.

Allergic: Rash and allergic reaction.Respiratory: Cough increased, pharyngitis, pleural effusion and rhinitis.Skin and Appendages: Eczema, fungal dermatitis, pruritus, sweating, urticaria and vesiculobullous rash.Special Senses: ConJunctivitis.Post-Marketing9 Experience: Adverse events reported with azithromycin during the post-marketing period inadult and/or pediatric patients for which a causal relationship may not be established include:-Allerg9ic: Arthralgia, edema, urticaria and anMqioedema.Cardiovascular Arrhythmias including ventricular tachycardia and hypotension.Gastrointestinal: Anorexia, constipation, dyspepsia, flatulence, vomiting/diarrhea rarely resulting. indehydration, pseudomembranous colitis, pancreatitis, oral candidiasis and rare reports ot tongue discoloration.General: Asthenia, paresthesia, fatigue, malaise and anaphylaxis (rarely fatal).Genitourinary: Interstitial nephritis and acute renal failure and vaginitis.Hematopoietic: Thrombocytopenia.Uver/Biliary: Abnormal liver function including hepatitis and cholestatic jaundice, as well as rare cases ofhepatic necrosis and hepatic failure, some of which have resulted in death.Nervous SysteFm Convulsions, dizziness/vertigo, headache, somnolence, hyperactivity, nervousness, agitationand syncope.Psychiatric: Aggressive reaction and anxietySkinAppndags: rurius,rarely serious slkin reactions including erythema multiforme, Stevens-Johnsonsyndomend txic pidemalnecrolysis.SpecalSnses Heaing istrbances including hearing loss, deafness and/or tinnitus and rare reports of taste

Perversion.Laboratory Abnormalities:Children:One, Three and Five Day RegimensLaboratory data collected trom comparative clinical trials employing two 3-day regimens (30 mg/kg or 60 mg/kgin divided doses over 3 days), or two 5-day regimens (30 mg/kg or 60 mg/kg in divided doses over 5 days) weresimilar for regimens of azithromycin and ail 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/mm'was observed in 10/64 patients receiving 30 mg/kg as a single dose, 9/62 patients receivinq 30 mg/kg givenover 3 days, and 8/63 comparator patients. No patient had an absolute neutrophil count <5 0 cells/mm3. (SeeDOSAGE AND ADMINISTRATION)In multiple-dose clinical trials involving approximately 4700 pediatric patients, no patients discontinued therapybecause of treatrrent-related laboratory abnormalities.

DOSAGE AND ADMINISTRATION (See INDICATIONS AND USAGE)Zithromaxl for oral suspension can be taken with or without food.Acute Otitis Media: The recommended dose of ZITHROMAX$ for oral suspension for the treatment of childrenwith acute otitis media is 30 mg/kg given as a single dose or 10 mg/kq once daily for 3 days or 10 mq/kg as asingle dose on the first day followed by 5 mg/kg/day on Days 2 through 5. The safety of re-dosing azithromycin inchiidren who vomit after receiving 30 mg/kg as a single dose has not been established. In clinical studiesinvolving 487 patients with acute otitis meaia given a single 30 mg/kg dose of azithromycin, eight patients whovomitea within 30 minutes of dosing were re-dosed at the same total dose.Convnunity-Acquired Pneumonia: The recommended dose of ZITHROMAX(@ for oral suspension for thetreatment of children with community-acquired pneumonia is 10 mg/kg as a single dose on the first day followedbv5 mgAgu on Days 2 though 5.%Paryngitis/Tonsillits: The recommended dose of ZITHROMAXO for children with pharyngitis/tonsillitis is

12 mg/kg once daily for 5 days.Formore detailedproduct information please refer to the fullprescribing information orcall 1M8079-3477.

Rev.9 January 2002

- ~~~~M1New York - I am a Pediatrician looking for a full orpart time clinic/practice setting in the New YorkCity area. Please call Susan at (212) 717-9505.

SOUTHEAST

ENERGETIC BC/BE PEDIATRICIAN WANTED tojoin dynamic, academically-oriented nationallyrespected practice in Dade, Broward and PalmBeach County, Florida. Immediate openings in ourPalm Beach locations. Unparalleled lifestyle forprimary care pediatrician with exceptional salaryand benefits. Reply to: Pediatric Associates, PA4620 North State Rd., 7 Ste., 316, LauderdaleLakes, FL 33319, Attention: Peter Shulman, M.D.,Physician Recruiting, or fax a current CV to (954)967-641 0.

Kentucky: BC/BE Pediatrician needed in HPSA loca-tion. J-1, Hl B permanent resident or U.S. citizen allwelcome. Computer literacy preferred. Send CV to:AAP 6, P.O. Box 969, Abingdon, MD 21009.

FLORIDA, Okeechobee. June 2003 opening.Community health center seeks experienced BCPediatrician. Bilingual (Spanish/English) preferred.Limited hospital. Competitive salary and great ben-efits including FTCA liability coverage. Fax resumeto: Medical Director, (561) 844-1013 or e-mailhrOfchcinc.org. EOE/DFWP

PRIMARY CARE PEDIATRICIAN - Atlanta, Georgia- Children's Healthcare of Atlanta is one of thelargest children's health care facilities in the coun-try. We have 430 licensed beds in 2 hospitals plus16 satellite locations throughout metro Atlanta,including 5 immediate care centers, 4 primary carecenters, and other facilities providing outpatientrehabilitation and other specialty care. We have acurrent opportunity available for a full-time PrimaryCare Physician who is fluent in Spanish. This indi-vidual will serve a primarily Hispanic populationand work out of our Chamblee, Georgia primarycare office in metro Atlanta, which is convenient toBuford Hwy. and inside 1-285. Please inquire aboutChildren's generous benefits. For considerationplease submit your CV to: Children's Healthcare ofAtlanta, Attention: Diane Pelzek, ManagerPhysician Recruitment, 1711 Tullie Circle NE,Atlanta, GA 30329; Fax: (770) 592-0917; Phone:(800) 773-4742. You may e-mail: diane.pelzekQachoa.org. For more information about Children's,please visit: www.choa.org. EOE - Children'sHealthcare of Atlanta.

NORTHWEST

NeonatologistThe Great Falls Clinic is looking for a BC/BENeonatologist interested in joining the Neonatologydepartment of a 100+ provider, multi-specialtyorganization. This position will provide the rightcandidate with the unique opportunity to work in aprogressive level 3 nursery engaged in multi-disci-plinary care; tackle challenging neonatal cases; workwith conventional/high frequency ventilation andnitric oxide therapy; and collaborate with a nation-ally recognized perinatologist, and broad base ofsubspecialty providers and surgeons. The Great FallsClinic does not qualify for J-1 waiver status. GreatFalls is a family-friendly community with excellentschools, low crime, clean air, and a reasonable costof living. In addition, you will have access to world-class recreational venues, outdoor activities, scenicvistas and regional culture right outside your prac-tice door. Qualified candidates will have excellentclinical and interpersonal skills, be a team playerand enjoy working closely with families and otherphysicians. The Great Falls Clinic offers a competi-tive benefit package and salary leading to partner-ship. For more information please submit CV andprofessional goals to Ray Geyer, D.O., MedicalDirector, Great Falls Clinic, LLP, 1400 29th St. South,Great Falls, MT 59405 or e-mail: ray.geyerEgfclinic.com.

-L -

;. r-=--,l D I 1--NIP-./-T\l--ll-. L!,)

Pediatric NeurologistThe Great Falls Clinic is looking for a full-time pedi-atric neurologist to join a Pediatric department thatconsists of a pediatric cardiologist, pediatric pul-monologist, 2 developmental pediatricians, pedi-atric ophthalmologist and 8 general pediatricians.This position will be office-based with hospital con-sultations, on-call duties limited to neurology con-sults only, and a desire to develop outreach clinics.Our local hospital has tertiary level NICU and abusy high-risk perinatology service. Great Falls isa warm and safe community perfect for a physicianinterested in making a home for themselves and/ortheir family. Access to world-class recreational ven-

ues, outdoor activities, scenic vistas and regionalculture right outside your practice door. Does notqualify for J-1 waiver status. Contact: Ray Geyer,D.O., Medical Director, Great Falls Clinic, P.O. Box5012, Great Falls, MT 59403-5012 or fax CV to:(406) 771-3021; or e-mail ray.geyerOgfclinic.com.Web site: www.gfclinic.com.

HARRI ET LAN E - REPORT TO DEVELOPI NGCOUNTRIES - The Children's Health OrganizationRelief and Educational Services (CHORES) andSepracor Inc. need your help in collecting used

copies of the Harriet Lane Handbook (1 5th EditionONLY) so that we may ship them to pediatricpractitioners in developing countries. Please shipto: CHORES, 1015 Atlantic Blvd. #155, AtlanticBeach, Florida 32233. We thank you. Check outCHORES - www.chores4kids.org.

PEDIATRIC BOARD REVIEW COURSE CoreContent - Comprehensive Review - NO PASS -

NO PAY!! St. Louis Oct. 12 - 16, 2003 43 AAPcredits Tuition: $795.00. www.pediatricboards.com. 1-800-MED-TEST (633-8378) pediatricboardsOaol.com.

Augmentin lamoxicillir/clavulanate potassium) is a registered trademark of GlaxoSmithKline.References: 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 otitis media. Paper presented at IDSA 38th Annual Meeting;September 7-10, 2000; Newv Orleans, La. Abstract 174.

45DU.S. PharmaeeutiealhAll rights reserved.ZX120881 G) 2002 Pfizer Inc.

June2003 www.aapnews.org AAPNews 2811

_ With~~~~~~~~~~~~Single Dose Zithromaxhsefcc oprbewt umn

to 2yeavetrfnsanw'_~~~~~~~~~~~~~~~~~~ihoa is_wfelltol;eraextaspos

I~~~~~~~~~~~~~~~~~Teoealicdneo advrs evets a 1.%fo ihrm[~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~~~~cmae wih2.%fL umni'

i A,;~~~~~~~~~g

5-

acy

innat

3nths