GLO.)'I 7J-!r 13;~~~ ~~ _-d-----

Marie Antonette Ramos, M.D.Unit #1 Vermont Square1 1 Sunrise Dr.CubaoQuezon City, 1109Philippines

Connecticut

Yong-Son Basta, M.D.57 Hickok Rd.New Canaan, CT 06840

Raelene Walker, M.D.1 1 Fairlawn Ave.Branford, CT 06405

Massachusefts

Marietta Calisto-Cooney, M.D.72 Summer St.Plymouth, MA 02360

Lisa Downs, Mb.D230 Willard St., #807Quincy, MA 02169

R. Alan Ezekowitz, M.D., Ch.B.15 Parkman St.Boston, MA 02114

Dianne Morris, M.D.19 Garden St.Cambridge, MA 02138

Harry Moskowitz, M.D.201 Norfolk St.Cambridge, MA 02139

Steve Tjoe-Fat, M.D.516 Shawmut Ave.Boston, MA02118

Kathryn Wiseman, M.D.295 Blair Rd.Williamstown, MA 01267

New HamphsireHeidi Gomes, M.D.1 5-A Dexter St.Derry, NH 03038

Vermont

Patnce Colander, M.D.675 Dog Team Rd.New Haven, VT 05472

New York 1

Mala Gaind, M.D.101 Crestview Dr., #C3Liberty, NY 12754

Carmen Lazala, M.D.3450 Wayne Ave., Apt. 1 8JBronx, NY 10467

New York 2

Inacia Besada, M.D.142 Main St., Apt. 1BMineola, NY 11501

Andria Chizner, M.D.235 W. Park Ave., #307Long Beach, NY 11561

Boris Marshalik, M.D.2966 Ocean Ave.Brooklyn, NY 11235

Grace Nunez-Russotto, M.D.77-51 75th St.Glendale, NY 11385

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

In submitting these names of board-certified pediatricians to you, it is understood that academicand pediatric credentials are not in question. Comments are requested concerning possible legaland/or ethical situations of which you might have personal knowledge.Send any comments on the following list of new applicants to your District Chairperson by Oct. 15.

Steven Perrick, M.D.819 Durham Rd.East Meadow, NY 11554

Maria Rodrigues, M.D.15 Harbor Ct., E.Roslyn Harbor, NY 1 1576

Roy Rodrigues, M.D.15 Harbor Ct., E.Roslyn, NY 11576

Andreas Sideridis,'M.D.42-19 195th St.Flushing, NY 11351

Robin Smith, M.D., M.B., B.Ch.247-71 77th Crescent,Bellerose, NY 11426

New Yorkc 3

AugustineAkalonu, M.D.RPO. Box 784,New City, NY 10956

Congenital Heart Surgery:Specialty Fellow:Gregory Crooke, M.D.3400 Bainbridge Ave., Ste. 5BBronx, NY 10467

Abdul Haleem, M.D.:6604 Grand Central Pkwy.:Forest Hills, NY 11375

'Alice Huang, M.D.436 E. 69th St., Apt. 2CNew York, NY 10021

Peter Kosoff, M.D.*474 West 238th St., #3-l:Riverdale, NY 10463

*Grace Lee, M.D.:1245 Park Ave., #4F*New York, NY 10128

*Abigail Trager, M.D.185 E. 85th St.:New York, NY 10028

Dima Rifai, M.D.Nibil GhalayiniRO. Box 13644Silver Spring, MD 20911

Ira Skolnik, M.D., Ph.D.2318 Bright Leaf WayBaltimore, MD 21209

Scott Winiecki, M.D.213 King Johns Ct.Churchville, MD 21028

New JerseyPriyadarshini Bhate, M.D.107 Loring Ave.Edison, NJ 08817

Lilyan Blatt, D.O.19 Sofia Ct.Blackwood, NJ 08012

Kathleen Chin, M.D.15 Tanglewood Dr.E Hanover, NJ 07936

Niels Giddins, M.D.200 Trenton Rd.Browns Mills, NJ 08015

TheresaJosue-Salcedo, M.D.73 Pike Dr., 1AWayne, NJ 07470

Lawrence Krawitz, M.D.1033 Route 46 EastClifton, NJ 07013

.

John O'Brien, M.D.1 1 1 1 Delta Rd.York, PA 17356

Charles Schwartz, M.D.750 S. Main St.Phoenixville, PA 19460

Robert Shelly, M.D.RR1 Box401ALewisburg, PA 17837

Tracey Trudel, M.D.1460 Blue Course Dr., Unit #22State College, PA 16801

Takeshi Tsuda, M.D.1138-1 Bibbs Rd.-Voorhees, NJ 08043

KentuckyeRima Mounla, M.D.e5010 Wolfpen Woods Dr. :Prospect, KY 40059

North Carolina

William Allen, M.D.153 Union PointeLn.:Lexington, NC 27295:

Tikee Aparece, M.D.1055 Mountain Valley Dr., #427Asheboro, NC 27203

Christopher Cerjan, M.D.101 GroverSt.Shelby, NC 28150

LisaAnn Gaffney, M.D.311 Terrastone PI.Cary, NC 27513

Catherine Hoffman, M.D.660 Summitt Crossing PI., Ste. 201Gastonia, NC 28054

Damon Korb, M.D.704 Shadylawn Rd.Chapel Hill, NC 27514

Melinda O'Leary, M.D.5208 Fortunes Ridge Dr.Durham, NC 27713

Julie Pinder, M.D.200 Robin Hood Med. Piz.Winston-Salem, NC 27106

South Carolina

Lisa Burns, M.D.25B Charlotte St.Charleston, SC 29403

Barry Cabiness, M.D.11 S. Canterbury Ct.Blythewood, SC 29016

,Cecily Hughes, M.D.606 Watford Ave.Greenwood, SC 29649

Kristin Moore, M.D.8120 Rourk St.:Myrtle Beach, SC 29572

:Todd Vasko, M.D.1164 Northbridge Dr.Charleston, SC 29407

Tennessee

Beverly Frank, M.D.101 Claytie St.Nashville, TN 37221

Karen Freeman, M.D.2201 Clinch Ave.Knoxville, TN 37916

:Padmajavani Veeramachaneni, M.D.:525 Laurel Pk. Dr.:#525 Legacy Hill Apts.*Nashville, TN 37205

Quynh W\§sniewski, M.D.3341 Stillcorn Ridge Rd.

*Columbia, TN 38401

*Virginia:Maria Teresa Angeles, M.D.2506 Sandy Spring Ln.Suffolk, VA 23434

*Walter Chun, M.D.:5901 Lakeside Ave.:Richmond, VA 23228

:Christine Houlihan, M.D.2900 Queensland Dr.*Richmond, VA 23294

Janette Mamuric, M.D.P.O. Box 829120 J. St.Keysville, VA 23947

Anita Maniktala, M.D.1320 Copperstone Cir.Chesapeake, VA 23320

David Masters, M.D.720 14th St.Waynesboro, VA 22980

Jean Oliver, M.D.330 W. Brambleton Ave.Norfolk, VA 23510

Juan Zambrano, M.D.Peds/AllergyBldg. MR-4 Rm. 5061Charlottesville, VA 22908

Indiana

Julia Foster, M.D.902 N. Meridian St., #321Indianapolis, IN 46204

Anita Joshi, M.D.1630 Lafayette Rd.Crawfordsville, IN 47933

Belinda Miller, M.D.600 N. Jordan Ave.Bloomington, IN 47405

Sandra Simmons, M.D.3722 W. 43rd Terr.Indianapolis, IN 46228

MichiganKimberly Augenstein, M.D.1108 Hill St.Traverse City, Ml 49684

Therese Benevich, M.D.2884 Roundtree Blvd.Ypsilanti, MI 48197

Paul Hennis, M.D.30065 Lochmoor St.Farmington Hills, Ml 48334

Sharon Mc Manus, D.O.42141 Mound Rd.Sterling Heigths, Ml 48314

Durdana Rehman, M.D.3276 Coolidge Hwy.Royal Oak, Ml 48073

Kim Winterhalter, M.D.563 Greenwood, SEGrand Rapids, MI 49506

Ohio

Robert Beekman, M.D.2342 Bedford Ave.Cincinnati, OH 45208

Stephen Davis, M.D.3120 Morley Rd.Shaker Heights, OH 44122

Natalie Jedacek, M.D.3591 Reserve Commons Dr.Medina, OH 44256

Laura Polakowski, M.D.4138 Georgetown Rd.Cincinnati, OH 45236

Renee Sandlin, M.D.21 16 Woonsocket Rd.Toledo, OH 43615

Balzer Sandrock, M.D.3611 Socialville-Foster Rd.Mason, OH 45040

Florida

Marcos Akerman, M.D.100 Bayview Dr., Apt. 1502North Miami Beach, FL 33160

Maria Cavero-Rankin, M.D.P.O. Box 4009Brandon, FL 33509-4009

Leon Cohen, M.D.2810 N. 46th Ave.Hollywood, FL 33021

Jamil Khan, M.D.P.O. Box 968Gotha, FL 34734

Maria Khan, M.D.P.O. Box 968Gotha, FL 34734

Marla Laufer, M.D.19830 NW 2nd St.Pembroke Pines, FL 33029

Lisa Plano, M.D., Ph.D.10640 SW 96th St.Miami, FL 33176

Richard Powell, M.D.4107 N. 51st Ave.Hollywood, FL 33021

Mary Stockett, M.D.401 Highway Al A, Unit 122Satellite Beach, FL 32937

Adilia Taylor, M.D.1089 Eagles Watch Tr.Winter Springs, FL 32708

Mariela Urbina, M.D.8260 W. Flagler St., Apt. 111Miami, FL 33144

Timothy Vaughan, M.D.8961 1 1 1 th St., N.Seminole, FL 33772

Eric Wurst, M.D.2517 Stoneview Rd.Orlando, FL 32806

Georgia

Greg Cabrera, M.D.'4819 Streamside Dr.Alpharetta, GA 30022

Idalia Gonzalez, M.D., M.P.H.3427 N. Druid Hills Rd., Apt. RDecatur, GA 30033

Ketna Mistry, M.D.939 Seville Dr.Clarkston, GA 30021

Sally Wright, M.D.1257 Beech Valley Rd.Atlanta, GA 30306

Louis Melchiorre, M.D.6 Larkspur Cir.Sicklerville, NJ 08081

Anita Parmar, M.D.3214 Gates Ct.Morris Plains, NJ 07950

Lisa Share, M.D.101 N. Newark Ave.Ventnor City, NJ 08406

Pennsylvania

Margot Butler, M.D.105 Polo Club Dr.Moon Township, PA 15108

Penny Chong, M.D.1009 Kathy Dr.Yardley, PA 19067

Stephanie Chorney, M.D.507 Grand St.Trenton, NJ 08611

Dennis Dlugos, M.D.59 Letitia Ln.Media, PA 19063

Jose Ettedgui, M.D.5814 Hampton St.iPittsburgh, PA 15206

Orthopaedics Specialty FellowJohn Flynn, M.D.34th & Civic Center Blvd.'Wood Bldg., 2nd Fl.Philadelphia, PA 19104

Rachel Hachen, M.D.2709 Oakford Rd.Ardmore, PA 19003

Sima Karpel-Shipon, D.O.1115 Devon Rd.Rydal, PA 19046

Susan Lombardozzi-Lane, M.D.102 Vista Dr.

:Greensburg, PA 15601

'Andrew Lubell, M.D.:601 Creek Dr.Ambler, PA 19002

*Delaware

:Thiele Anthony, M.D.26 Rivers End Dr.

*Seaford, DE 19973

*District of Columbia

Deepika Darbari, M.D.:2634 Antler Ct.*Silver Spring, MD 20904

Matthew Dever, M.D.*4000 Tunlaw Rd. NW, Apt. 80~Washington, DC 20007

*Maryland:Frances Bird, M.D.23 Clovelly St.

.Pikesville, MD 21208

Samer El-Kamary, M.D..7013 G. Lachlan Cir.:Baltimore, MD 21239

:Giorgio Kulp, M.D.7864 Heatherton Ln.*Potomac, MD 20854

*Robin Larabee, M.D.:652 Pinewood Dr.:Annapolis, MD 21401

:Sharon Mc Fayden-Eyo, M.D.28295 Early Dawn Ct.

*Salisbury, MD 21801

13

38 AAP News September 1999

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Alabama

Lisa Haab, M.D.3920 Airport Blvd.Mobile, AL 36608

Arlene Hay, M.D.P.RO. Box 6801991~Fort Payne, AL 35968

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Constantina Spiropoulos, M.D.560 Missouri Ave.Cincinnati, OH 45226

Dianna Tolen, M.D.3457 42nd St.Canfield, OH 44406

Kathleen Trela-Fulop, M.D.595 Copeland Mill Rd.Westerville, OH 43081

Ontario

Anh Do, M.D.127 Braemar Ave., UpperToronto, ON M51P 21-3Canada

Hirotaka Yamashiro, M.D.2712-38 Elm St.Toronto, ON M5G 2K5Canada

Illinois

-

California 1

Ejaz Ahmed, M.D.572 Rio Lindo Ave.Chicao, CA 95926

Carol-Lynn Barsky, M.D.1526 Apple Creek Ln.Santa Rosa, CA 95401

0Wisconsin

'Roopa Karri, M.D.,3501 Lake Shore Rd., Apt. 3DSheboygan, WI 53083

Teri Stevenson, M.D.733 W. Clairemont Ave.Eau Claire, WI 54701

,MatthewTheado, M.D.:323 S. 18th Ave.Sturgeon Bay, WI 54235

*Texas

:Gary Brown, D.O.:6017 76th St.*Lubbock,TX79424

Nancy Dickason, M.D.*4110 Bellaire Blvd., Ste. 210Houston, TX 77025

:Suzanne Dugopolski, M.D.:6012 E. Lovers Ln., #220Dallas, TX 75206

Barbara Durso, M.D.1018 Cordova St.

*Dallas,TX75223

:Caradolo Femandes, M.D., M.B., B.S.:6621 Fannin St., #A340*Houston, TX 77030

Hoda Gabriel, M.D.*6750 Tezel Rd., Ste. 103San Antonio, TX 78250

:Maged George, M.D., M.B., Ch.B.:3333 S. Alameda, Apt. 1 H.Corpus Christi, TX 78411

Lucy Graubard, M.D.*1 1622 Coachfield Ln.Houston, TX 77035

:James Hill, M.D., Ph.D.:109 Shult Dr.*Columbus,TX78934

Erin Holsinger, M.D.*1630 Fountain ViewHouston, TX 77057

:Emad Kaldas, M.D., M.B., B.Ch.:6630 Quaker Ave., Ste. I*Lubbock, TX 79413

Glenn Lawrence, M.D.1600 University Dr.

*College Station, TX 77840

:Susan Mandell, M.D.: 1300 W. Lancaster Ave., Ste. 101*Ft. Worth, TX 76102

Tuan Nguyen, M.D..10503AdamsboroughHouston, TX 77099

:Umesh Pathak, M.D.:866 Quail Hollow Dr., S.Weslaco, TX 78596

*Kalyani Raja, M.D.*303 Overton Rd.*Dallas, TX 75216

:Betty-Ann Svendsen, M.D.:1600 University Dr., E.*College Station, TX 77840

Nancy Mc Kenzie, M.D.1278 Finn Ave.Littleton, CO 80124

Daniel Miga, M.D.2121 S. Oneida, Ste. 200Denver, CO 80224

Lisa Scharp, M.D.2853 Odell Dr.Erie, CO 80516

Hawaii

Anthony Guerrero, M.D.2159 Oko'a St.Honolulu, Hi 96821

Nevada

Eileen Benway, M.D.*2165 East St.:Concord, CA 94520

:Brian Cassidy, M.D.: 112 Clifford Terr..San Francisco, CA 94117

*Jeffrey Corral-Ribordy, M.D., M.P.H.*2800 Harris St.*Eureka, CA 95503

:Ethan Cutts, M.D.:8406 Ruggles Ct.*Fair Oaks, CA 95628

*Michelle Ernst, M.D.1405 Racquet Club Dr.Auburn, CA 95603

:Jeffrey Gaborko, M.D.:3700 Vaca Valley Pkwy..Vacaville,CA95688

*Kimberly Jones, M.D.*1326 Hoover St.*Menlo Park, CA 94025

:Edmun Leo, M.D.:20160Orion Ct..San Leandro, CA 94579

Kristine Norton, M.D.*1600 Villa St., #145:Mountain View,CA94041

:Misha Roitshteyn, M.D.:2243 Mowry Ave..Fremont,CA94538

*Karen Sharpe, M.D.*900 S. FairmontAve.Lodi, CA 95240

:Chandran Shanmugam, M.D.:51 Benton Ave.San Francisco, CA 941 12

Richard Singer, M.D.1036 Pinehurst Ct.*Concord,CA94521

:Sima Stein, M.D.:10944 Stonebrook Dr.Los Altos Hills, CA 94024

*Kathleen Sweeney, M.D.*3131 Warren Ln.El Dorado Hills, CA 95762

:James Trietsch, D.O.:39083 Road 425B*Oakhurst,CA93644

George Van Hare, M.D.*750 Welch Rd.Palo Alto, CA 94304

:Virginia Vierra, M.D.:690MariposaAve..Oakland,CA94610

Jamie Wallach, M.D.515 Fox St., W.*Redwood City, CA 94061

.California 2

Katrina Dipple, M.D., Ph.D.10833 Le Conte Ave.

.Los Angeles, CA 9(XJ95

Denise Garvey, M.D.: 1131 Wilshire Blvd., Ste. 200:Santa Monica, CA 90401

Soo Kim, M.D.10650 Mountain View, #302*Redlands, CA92373

.Roy Lin, M.D.:2700 Grant St.:Concord, CA 94520

Evan Steinberg, M.D.328 Auburn Ave.

.Sierra Madre, CA 91024

Michelle Thompson, M.D.:1900 N. Vine#408*Los Angeles, CA 90068

DISTRICT I

Eileen M. Ouellette, M.D., J.D.APediatric NeurologyANorth Shore Children's HospitalA57 Highland Ave.ASalem,MA01970

.*e-mail: eouelletteOaap.org

*DISTRICT 11

*6 Louis Z. Cooper, M.D.*0 Department of Pediatrics*Columbia University*Room BHS 114*630 W. 168th St.*New York, NY 10032e-mail: IcooperOaap.org

DISTRICT III

Susan S. Aronson, M.D.a605 Moreno Rd.aNarbeth, PA 19072

* e-mail: saronsonEtaap.org

*DISTRICT IV

*E. Stephen Edwards, M.D.*0 2800 Blue Ridge Blvd.*Suite501*Raleigh, NC 27607e-mail: sewardsOaap.org

DISTRICT V

Stanford A. Singer, M.D.a36700Woodward Ave.aSuite300aBloomfield Hills, MI 48304e-mail: ssingerOaap.org

DISTRICT VI

*Ordean L. Torstenson, M.D.*Dean Medical Center, SC

*0 1313 Fish Hatchery Rd.* Madison, WI 537150e-mail: otorstensonOaap.org

DISTRICT Vll

L. Leighton Hill, M.D.a Ofce of AdmissionsaBaylor College of MedicineaOne Baylor Plaza, Rm. N104aHouston,TX77030ae-mail: IhillOaap.org.DISTRICT VIll

* Jon R. Almquist, M.D.* Virginia Mason Medical Center* Department of Pediatrics*33501 First Way South*Federal Way, WA 980030e-mail: jalmquistQaap.org

0DISTRICT IX

0Lucy S. Crain, M.D., M.P.H.a UCSF Box 0374a 400 Parnassus Ave.a San Francisco, CA 94143ag e-mail: IcrainOaap.org

,Michael Goralka, M.D.123 Lotus Cir.Carson City, NV 89703

New Mexico

Eric Colgrove, M.D.P.O. Box 3717Shiprock, NM 87420

Erika Fernandez, M.D.3301 Valley Haven Ct., NWAlbuquerque, NM 87107

OregonSona Mehra, M.D., M.B., B.S.:5415 SW Westgate Dr.Portland, OR 97221

Robin Yurk, M.D., M.P.H.1710 SW Harbor WayPortland, OR 97201

Unifonned Services - We!

.TammyMeehan, M.D.3419 Wren Rd.:Birmingham, AL 35243

:Arkansas

Angela Fangmeier, M.D.1477 Andrew Ct.Siloam Springs, AR 72761

:Eugene Lu, M.D.:416 N. Pierce St..Little Rock, AR 72205

Deborah Massey, M.D.223 Linwood Ct.

.Little Rock, AR 72205

:Chrisandra Sico-Davis, M.D.:3320 Golf Course Dr..Alma,AR72921

*Louisiana

Sanjay Garg, M.D., M.B.B.S.:1022 Port Arthur Terr.Leesville, LA 71446

:Lisa Le, M.D.4315 Houma Blvd.

*Metairie, LA 70006

*Sandy Reed, M.D.9191 Bluebonnet Blvd.:Baton Rouge, LA 70810

:Lynne Seoane, M.D.6616 Canal Blvd.*New Orleans, LA 70124

*Carlos Vides, M.D.:71107 Highway 21:Covington, LA 70433

:MississippiCarlos Bruno, M.D.*3602 17th St.Gulfport, MS 38501

:Scott Burks, M.D.: 1101 S. 28th Ave..Hattiesburg, MS 39402

Katherine Deye, M.D.*409 Vandenberg Dr.Biloxi, MS 39531

:Davor Skaricic, M.D.:1525 Grove Ridge, Apt. 102:Germantown, TN 38138

:Oklahoma

*Krisztina Balazs, M.D.:1005 Red Oak:Sffllwell, OK 74960

:Mary Blue, M.D.9700 S. Penn.Oklahoma City, OK 73159

*Herschel Scher, M.D.:940 NE 13th St..Oklahoma City, OK 73104

Ayisha Bahauddin, M.D., M.B.B.S.906 Cynthia Ln.Lake In The Hills, IL 60102

Erin Flanagan-Klygis, M.D.2500 N. Lakeview Ave.Chicago, IL 60614

Annie Huang, M.D.1010 Brighton Dr.Wheaton, IL 60187

Deepa Ranganathan, M.D.5841 S. Maryland Ave.,MC6060Chicago, IL 60637

James Tucker, M.D.3125 Copper Creek Rd.Bloomington, IL 61704

Iowa

William Renk, M.D.855A. Ave. NE, Ste. 300Cedar Rapids, IA 52402

Kansas

Michael Greenfield, M.D.801 N. Mur Len Rd.Olathe, KS 66062

Ann Sachs, M.D.5846 SW 26th Terr.Topeka, KS 66614

Minnesota

Shefi Schechinger, M.D.7250 France Ave. S, Ste. 310Edina, MN 55435

Dermatology Specialty FellowJulie Winfield, M.D.4500 Cosco Ave.Edina, MN 55424

Missouri

Douglas Evans, D.O.1419 Village Dr.St Joseph, MO 64506

Leigh Griggs, M.D.9941 Warshire Dr.St Louis, MO 63132

Ayesha Najib, M.D.133 Cedar Cove Tr.Lake St Louis, MO 63367

Nebraska

Joel Greisen, M.D.7100 Holmes Park Rd., Apt. 315Lincoln, NE 68506

Michelle Walsh, M.D.5400 S. 73rd St.Lincoln, NE 68516

mst

Thomas Connolly, M.D.PSC 78 Box 3423APO, AP 96326

Donald Kane, D.O.2137 Castle Ct.Clovis, NM 88101

Julie Messner, M.D.1100 Lambrusco Dr.Harker Hts, TX 76548

,Michael Stoner, M.D.1 1 6-A Penn Cir.Grand Forks AFB, ND 58204

'Utah

Winifred Hobson, M.D.1206 S. 1000 EastSalt Lake City, UT 84105

'WashingtonDeborah Agnew, M.D.518W. 1st Ave.Toppenish, WA 98948

Shakti Matta, M.D.:2263 W. Mockingbird Ln., Unit B:Othello, WA 99344

Steven Schiebel, M.D.13030 121st Way NE

*Kirkland, WA 98034

*Ronald Siegemund, M.D.:RPO. Box 13102:Oakland, CA 94661

Michael Tomkins, M.D.P.O. Box 95403

*Seattle, WA 98145

:Arizona

Jeffrey Couchman, M.D.:8931 E. Chauncey St.:Tucson, AZ85715

:David Galles, M.D.117 W. Seldon Ln.

*Phoenix, AZ 85021

Mary Jo Kutler, D.O.*4545 E. Chandler Blvd.:Phoenix, AZ 85044

:Leonard Seltz, M.D.4317 N. Rio Cancion, #210.Tucson, AZ 85718

00000

.

:oAmerican0'Academy of

*l Pediatrics'.Colorado

Lynn Bullock, M.D.6197 Lehman Dr.Colorado Springs, CO 80918

Debra Efird, M.D.1583 S. Emerson St.Denver, CO 80210

September 1999 AAP News 39

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A CME meeting in practical pediatric topi'cs and 11|Right Thing... tlcG ou0practicemanagementseminar 1

The Sisters of the( ~~ 1l | ~Third Order of St. Francis (OSF) have been providing med-g f 11 1 ~~~~ical carefor residentsof Illinois, IowaandMichigan formore

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October 21-24, 1999 lllPeoria, Illinois * Escanaba, MichiganSHERATON BUCKHEAD ATLANTA lllFormore information, please contactA. C,eraldIc Reistiian, A,1:)J 1-roqryain? Cb1air ll| Wendy Bass at (800) 462-3621; Fax (309) 65-2574;

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September 1999 AAP News 411

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NATIONAL

PEDIATRIC RECRUITMENT SPECIALIST -Locating and eval-uating practice opportunities available nationwide for generalpediatrics/subspecialties. To discuss your interests, contact:Julie Stoehr, Medical Staffing Associates, 6731 Whittier Ave.,3rd Fl., McLean, VA 22101. (800) 235-5105. Fax: (703) 893-7358. e-mail: dconwayEserviceusa.com . Internet:http://www.rnedstaffer.corn.

MID-ATLANTIC

NORTHERN VIRGINIA -Growing PEDIATRIC practice inSterling, Va., with a reputation for excellence, looking forBC/BE pediatrician to add to our team. Approximately 30minutes west of Washington, D.C., just minutes from the sce-nic rural countryside of the Blue Ridge Mountains. Many cul-tural and recreational opportunities; excellent neighborhoodsand schools. Position is available now with a flexible startingdate. Competitive salary with good benefits package. Pleasecontact Shara Messick: (703) 444-2675 or 444-3245 or sendCV to Pediatric HealthCare, PC; 46440 Benedict Dr., Ste. 207,Sterling, VA 20164; fax (703) 444-0386; e-mail: misty.moun-tainOcwix.com.

MIDWEST

CHAIRPERSON, DEPARTMENT OF PEDIATRICS, COOKCOUNTY HOSPITAL seeks a dynamic pediatrician and expe-rienced medical administrator and academic physician to leada dedicated faculty and residency group that delivers overxOOO patient days and x000 ambulatory encounters/year. TheChairperson at Cook County Hospital will also serve as Vice-Chair of the Department of Pediatrics at Rush Medical College.The institutional mission is to serve the medically indigent andis committed to diversity at all organizational levels. Interestedcandidates may send CV to Carolyn Lopez, M.D., Chair, SearchCommittee, c/o Department of Family Practice, 1900 W. Polk13th Fl., CCAB, Chicago, IL 60612; fax: (312) 633-8813.EOE/AA Employer.

NORTHWEST

NEONATOLOGIST/PORTLAND, OREGON -NorthwestPermanente, P.C. has an excellent opportunity for a BC/BEneonatologist to join one neonatologist in a stimulating pro-fessional environment with one of the most successful man-aged care systems in the country and enjoy a quality lifestyleinherent to the beautiful Pacific Northwest! Our physician-managed multispecialty group, who provides care for over.440,000 members of Kaiser Permanente, has a full-time posi-

Growing, four-physlc'ian, system-owned practice seeks BC/BE Pediatricianl.Office just two blocks from 226-bed Chambersburg Hospital, including afull-time Pediatric Nurse Practitioner.

~~~~Chambersburg is located in southcentral PA -where,5 NEWYORY : you will find the splendor of the mountains, lakes,

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awlug Phibdephia For more information, cal or send your C. V: to:

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71 Ihemanageet ofall pediatric medical cases at our ntna Clinic and 24 hour Alarm Cenr7I Coodnaig and p I1- mpediatric medical wvacuain fluoughout Noith AsiaWI Planning and developingor pediatric medfical services imi the PRC, with an enphasis on quality improvemenlt

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Pediatricians kew to explorethis oppoauny should contact Dr Myles Drucka, Ara Medical Dieor - NoitEast Asia on tel: 8610 6462 9199. Alematively res maw ca be faxed imefiatelyto Dr Dludkman in Beijing onfax: 8610 6462 9111 or by emil: myles.druckmanilaeainfl.com or aliso.brownSlacainfl.com

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g; .: ^,,>,4,<,<,g g.,fl-k'N ., ' I .7,)jf(-g

References: 1. Greenberg RN. Overview of patient compliance with medication dosing: a literature review. Clin Ther.1984;6:592-599. 2. Red Book't Update, Montvale, NJ: Medical Economics Co Inc; July 1998:22,24,26,27,71.

ZITHROMAX"lazithromycin 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 poatient populations vary amona theseinfections, please see DOSAGE AND ADMINISTRATION for specific dosing recommendations.

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

Community-acquired pneumonia due to Chlamydia pneumoniae, Haemophilus influenzae, 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 asany of the following: patients with cystic fibrosis, patients with nosocomially acquiredinfections, patients with known or suspected bacteremia, patients requiring hospitalization,or patients with significant underlying health problems that may compromise their ability torespond to their illness (includingl immunodeficiency or functional asplenia).

Pharyngitir./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. ZITHROMAX' is often effective in the eradication ofsusceptible strains of Streptococcus pyogenes from the nasopharynx. Because some strains are resistant toZITHROMAX', susceptibility tests should be performed when patients are treated with ZITHROMAXR 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, antimicrobial therapy should be adjusted accordingly.

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

WARNINGSSerious allergic reactions, including angioedema, anaphylaxis, and dermatologic reactions including StevensJohnson Syndrome and toxic epidermal 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 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 thelong tissue 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 treafanent of pneumonia, azithromycin has only been shown to be safe and effective in thetreatmnent of community-acquired pneumonia due to Chlamydia pneumonine, Haemophilus influenzae,Mycoplasma pneumoniaes, or Streptococcus pneumoniae, 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 problems that may compromise their ability to respond to their illness (includingimmunodeficiency or functional asplenia).

Pseudomembranous colitis has been reported with nearly all antibacterial agents and may range insevernty from mild to life-threatening. Therefore, it is important to consider this diagnosis in patientswho present 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, andtreatment 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,they have been reported with macrolide products: 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 Patients: Patients should be cautioned to take ZITHROMAXI suspension at least one hour prior toa meal or at least two hours after a meal. This medication should not be taken with food.

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

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

Administration of cimetidine (800 mg) two hours prior to azithromycin had no effect on azithromycin absorption.Azithromycin did not affect the plasma levels or pharmacokinetics of theophylline administered as a single

intravenous dose. The effect of azithromycin on the plasma levels or pharmacokinetics of theophylline administeredin multiple doses resulting in therapeutic steady-state levels of theophylline is not known. However, concurrent useof macrolides 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 leveis 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 clinicai practice has been associated with increasedanticoagulant 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 Interactions: There are no reported laboratory test interactions.Carcinogenesis, Mutagenesis, Impairmnent of Ferility- Long-term studies in animals have not been performedto evaluate carcinogenic potential. Azithromycin has shown no mutagenic potential in standard laboratory tests:

tion available for a BC/BE neonatologist at astate-of-the-art Level III NICU in one of ouraffiliated medical centers in suburban Portland.Duties involve covering Level III and 11 new-borns in an expanding 30-bed unit, as well ascoordinating newborn services in the greaterPortland area. Call is shared with a largerneonatal group. We offer our physicians acompetitive salary and a benefits package,which includes a generous retirement pro-gram, professional liability coverage, sabbati-cal leave and more. For information regardingthese exciting opportunities, please forwardCV to: A.P. Clark, Director of ProfessionalResources, Northwest Permanente, P.C., 500NE Multnomah, Ste. 100, Portland, OR97232-2099. EOE.

TEXAS PEDIATRIC SOCI ETY/TEXASCHAPTER AN NUAL MEETI NG -Sept.24-26, 1999, Westin Galleria Hotel,Houston. Contact: Mary E. Greene,Executive Director, 401 W. 15th St., Ste.682, Austin TX 78701. Phone: (512) 370-1506, e-mail: tpsmgreeneX?aol.com, Website: http://www.txpeds.org.

" PEDIATRICS FOR THE PRACTITIONER"-Big Island, Hawaii, Oct. 11-14, 1999.Sponsored by Saint Luke's Hospital and theChildren's Mercy Hospital of Kansas City. Call(816) 932-2220 or send e-mail to cmeRsaint-lukes.org for information.

"PEDIATRIC INFECTIOUS DISEASE SEMI-NAR" -(1 1tth Annual Lloyd Noland), at theWyndham Place, Wait Disney World, Florida,Oct. 20-23, 1999. Faculty: Drs. Chadwick,Chesney, Lieberman, Littman & Rennels. Call,fax or write: George M. Converse 111, M.D.,FAAP, Department of Medical Education,Lloyd Noland Foundation, P.O. Box 925,Fairfield, AL 35064-0925. Phone: (205) 783-5276 (voice & fax). Visit the Lloyd NolandCME Web site: http://www.Iloydnoland-cme.org.

14TH ANNUAL "SAN DIEGO CONFERENCEON RESPONDING TO CHILD MALTREAT-MENT" -Jan. 24-28, 2000, Town & CountryResort Hotel & Convention Center, San Diego,

mouse lymphoma assay, human lymphocyte clastogenic assay, and mouse bone marrow clastogenic assay.No evidence of impaired fertility due to azithromycin was found.Pregnancy: Teratogenic Effects. Pregnancy Category B: Reproduction studies have been performed in rats and miceat doses up to moderately maternally toxic dose levels (i.e., 200 mg/kg/da,v). These doses, based on a mg/m2 basis,are estimated to be 4 and 2 times, respectively, the human daily dose of 500 mg. In the animal studies, no evidenceof 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 1 followed by 5 mg/kg on Days 2-5): Safety andeffectiveness in the treatment of children with otitis media under 6 months of age have not been established.

Community-Acquired Pneumonia (dosage regimen: 10 mg/kg on Day 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 Mycoplasma 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 difficultyin obtaining specimens. Use of azithromycin for these two microorganisms is supported, however, by evidence fromadequate and well-controlled studies in adults.

Pharyngitis/Tonsillitis (dosage regimen: 12 mg/kg on Days 1-5): Safety and effectiveness in the treatment ofchildren with pharyngitis/tonsillitis under 2 years of age have not been established.

Studies evaluating the use of repeated courses of therapy have not been conducted.Geriatric Use: Pharmacokinetic parameters in older volunteers 165-85 years old) were similar to those in youngervolunteers (18-40 years old) for the 5-day therapeutic regimen. Dosage adjustment does not appear to be necessaryfor older 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 ZITHROMAX' (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 ZITHROMAXI were related to the gastrointestinal system with diarrhea/loose stools 15°h).nausea 13%), and abdominal pain 13%) being the most frequently reported.

No other side effects occurred in patients on the multiple-dose regimen of ZITHROMAX4 with a frequency greaterthan 1%. Side effects that occurred with a frequency of 1% or less included the following:Cardiovascular Palpitations, chest pain.Gastrointestinal: Dyspepsia, flatulence, vomiting, melena, and cholestatic jaundice.Genitourinary: Monilia, vaginitis, and nephritis.Nervous System: Dizziness, headache, vertigo, and somnolence.General: Fatigue.Allergic: Rash, photosensitivity, and angioedema.Single 1-gram dose regimenr. 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 ZITHROMAX' with a frequency ofI% or greater included diarrhea/loose stools 17%), nausea l5%), abdominal pain (5%), vomiting l2%), dyspepsia (11%),and vaginitis ll%).Single 2-gram dose regimen:- Overall, the most common side effects in patients receiving a single 2-gram dose ofZITHROMAX'- were related to the gastrointestinal system. Side effects that occurred in patients in this study with afrequency of 1% or greater included nausea ll8%), diarrhea/loose stools ll4%), vomiting l7%), abdominal pain l7%).vaginitis l2%), dyspepsia ll %), and dizziness ll %). The majority of these complaints were mild in nature.Children: Multiple-dose regimensT. The types of side effects in children were comparable to those seen in adults,with different incidence rates for the two dosage regimens recommended in children.

Acute Otitis Media: For the recommended dosage regimen of 10 mg/kg on Day 1 followed by 5 mg/kg onDays 2-5, the most frequent side effects attributed to treatment were diarrhea/loose stools l2%), abdominal pain l2%),vomiting ll%), and nausea 0l%).

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 l5.8%),abdominal pain, vomiting, and nausea ll.9% each), and rash ll.6%).

Pharyngitis/tonsillitis:. For the recommended dosage regimen of 12 mg/kg on Days 1-5, the most frequent sideeffects attributed to treatment were diarrhea/loose stools l6%), vomiting l5%), abdominal pain l3%), nausea l2%),and headache ll%).

With either treatment regimen, no other side effects occurred in children treated with ZITHROMAXI with afrequency of greater than I1%. 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 lotitis 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.Cardiovascular Arrhythmias including ventricular tachycardia.Gastrointestinal: Anorexia, constipation, dyspepsia, flatulence, vomiting/diarrhea rarely resulting in dehydration.General: Asthenia, paresthesia.Genitourinary: Interstitial nephritis and acute renal failure.Liver/Biliary: Abnormal liver function including hepatitis and cholestatic jaundice.Nervous System: Convulsions.Skin/Appendages: Rarely serious skin reactions including erythema multiforme, Stevens Johnson Syndrome, andtoxic epidermal necrolysis.Special Senses: Hearing disturbances including hearing loss, deafness, and/or tinnitus, rare reports of tastedisturbances.Laboratory Abnormalities: Adults: Significant abnormalities (irrespective of drug relationship) occurring duringthe clinical trials were reported as follows: with an incidence of 1-2%, elevated serum creatine phosphokinase,potassium, ALT lSGPT), GGT, and AST lSGOT); with an incidence of less than 1%, leukopenia, neutropenia,decreased platelet count, elevated serum alkaline phosphatase, bilirubin, BUN, creatinine, blood glucose, LDH,and phosphate.

When follow-up was provided, chang'es in laboratory tests appeared to be reversible.In multiple-dose clinical trials involving more than 3000 patients, 3 patients discontinued therapy because of

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

DOSAGE AND ADMINISTRATION (See INDICATIONS AND USAGE.)Acute Otitis Media and Community-Acquifed Pneumonia: The recommended dose of ZITHROMAX' for oralsuspension for the treatment of children with acute otitis media and community-acquired pneumonia is 10 mg/kg asa single dose on the first day (not to exceed 500 mg/day) followed by 5 mg/kg on days 2 through 5 (not to exceed250 mg/day).Pharyngitis/Tonsillitis: The recommended dose for children with pharyngitis/tonsillitis is 12 mg/kg once a day for5 days (not to exceed 500 mg/day).ZITHROMAX' for oral suspension should be given at least I hour before or 2 hwrs after a meal.ZlTHROMAX" for oral suspension should not be taken with food.More detailedprofessional information available on requestRevised January 1997

L

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ADOLESCENT MEDICINE SEMINAR-(8th Annual Lloyd Noland), at the BuenaVista Place, Walt Disney World, Florida,Feb. 2-5, 2000. Call, fax or write: GeorgeM. Converse 111, M.D., FAAP, Departmentof Medical Education, Lloyd NolandFoundation, P.O. Box 925, Fairfield, AL35064-0925. Phone: (205) 783-5276(voice & fax). Visit the Lloyd Noland CME

Web site: http://www.lloydnoland-cme.org.

PEDIATRICS SEMINAR "ADVANCES &CHANGING TRENDS" -(011th Annual LloydNoland) at the Wyndham Palace, Walt DisneyWorld, Florida, March 15-18, 2000. Call, faxorwrite: George M. Converse III, M.D., FAAP,Department of Med ical Ed ucation, LloydNoland Foundation, P.O. Box 925, Fairfield, AL35064-0925. Phone: (205) 783-5276 (voice &fax). Visit the Lloyd Noland CME Web site:http://www.lIoydnoIandcme.org.

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September 1999 AAP News 43

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Pediatric Health

COVERAGE OF KEY RESPIRATORY PATHOGENS

TY PI CAL ATY PICA 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 arediarrhea/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, orS pneumoniae, and community-acquired pneumonia due to C pneumoniae, H influenzae, M pneumoniae, orS pneumoniae.Oral azithromycin should not be used in pediatric patients with pneumonia who are judged to be inappropriatefor oral therapy 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 suspected bacteremia,patients requiring hospitalization, or patients with significant underlying health problems that may compromisetheir ability to respond to their illness (including immunodeficiency or functional asplenia).

5 once-d~~ail oe(efcc ha' ayfo orltteptetst ae

Please see brief summary of prescribinginformation on adjacent page.