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|AUDIO CASSETTE ORDER FORM
Each progrlam consists oftwo cassettes, $22aoo, unless oheriWse noted
BONUS OPTIONS* BUY 6 CASSETES, RECENE THE 7TH
CASSETTE FREE!* BUY 12 CASSETES, RECEWE A FREE
STOPAGE ALBUM.*D BUY ENTIRE SET, RECEIVE A20% DISCOUNT AND A FREE
STOPAGE ALBUM.
PLEASE CHECKDESUtED PROGRAM ABOVE THEN COMPLETE AND RETURN ENTIRE FORMSEND TO: TEACHEEM160 EAST 19ILINOIS STREET, CHICAGO, EL 60611
Phone: (312) 467-0424 * Fax: (312) 467-9271 Credit Cards Only * Toll Free: 1-800-225-3775 * E-Mail: teach`emgbonus-books.com
AMOUNT OF ORDER S(IL REII)ENTS ADD 8.75% SALES TAX) S NAME TITLE
SHIPPING 1& HANDLING S 4-00.TOTAL(INU.S.FUNDS) S ORGANIZATIO
OCHECKENCLOSEDPAYABLE TO TEiACH EM |ADDRESS (NO P.O. BOXES)
CITY STATE ZI
CARD# |TELEPHONE ( )_SIGNATUREEXPIRLATIONDATE |Please Note: Any defective tape(s) will be replaced, but tapes are non-refiindable.
IAMERICAN ACADEMY OF PED4IATRCS
1997 AL\nnucd Meet'ingNovember I - 5 * New Orleans, LA
OAAP 755 (H706) SECTION ON SURGERYPediatric Oncology; Malignant Germ CellTumors; Malignant Sacrococcygeal Teratomas;Testicular Germ Cell Lesions; Ovarian GermCell Lesions
OAAP 756 (S101) Disorders that Mimic ADHD:Misdiagnosis of Attentional Problems
OAAP 7111 (S102) Pearls in Practical Ophthalmologyfor the Pediatric Practitioner
O3AAP 757 (S103) Common Genitourinary Problems:Evaluation and Managemnent
OAAP 761 DIALOGUE SESSION PM: AlternativeTherapy in Neurology: You Want to Do Whatto Your Child?Treatment of Headaches and Cerebral Palsy;Traditional Approach to Cerebral Palsy;Alternative Approach to Seizures
O3AAP 7112 (S119) Office Mangmn and HealthSupervision of Children with Common GeneticDisorders
OAAP 762 (S122) Management of CommonBacterial and Viral Infections
O3AAP 759 (H127) Section on Allergy and 1nuo-ogy: Hot Topics in Pediatric Allergy, Asthma,and Imnlogy...3 cassettes, $33
O3AAP 760 (J130) A Virus Called FireanmsO3AAP 766 DIALOGUE SESSION AM
New Developments in Breastfeeding Inants;Growthi Patterns and Breastfed Inants; nfants/Parent Bed Sharing; Insufficient MilkSyndrome
OAAP 767 (S204) Controversies and Updates inPediatric Emergency Medicine
O3AAP 768 (S206) Adolescent Addiction Seminar IO3AAP 769 (J209) Violence and Children: What Are
We Doing and Where Do We Stand?OAAP 764 (H211) Section on Allergy and
Imuoogyhnnteapy in Asthma; Nebulizer Use for
Asdua in Children Less Than 3 Years Old..9.3 cassettes, S33
OAAP 76S (H213) Section on Administration andPractice Management and the ResidentSection-Entering Practice: The Early Years..3 cassettes, $33
OMAP 763 (E1232) Section on OrthopaedicsKeynote Address: "Early Surgical Repair ofBrachial Plexcus Birth Injuries" (John P.Laurent, M.D., FAAP)...3 cassettes, $33
O3AAP 770 DIALOGUE SESSION PM: PediatricGastro-esophageal Reflux; Results ofTreatmnent
O3AAP 771 (S223) Antibiotics and AntiviralsOIAAP 7116 (S226) Common Pediatric ENT ProblemsO3AAP 7119 (S227) Abdominal Pain in the School-
Aged ChildO3AAP 77 PLENARY SESSION AM
President's Address (Robert E. Hannewmun,M.D., FAAP); Keynote Address (Captain GeneCernan); Resistant Pneumnoccocal Infections;Bacterial Toxcin Disease; Prevention ofPerinatal HIV; Future of Pediatric Education
O3AAP 774 (S304) Promoting Breastfeeding in thePediatric Office
O3AAP 77S (S338) Introduction to ImnlogyOAAP 776 (H317) Section on Infectious Diseases-
Emerging Infections in PediatricsEmerging Viral and Rickettsial Inections;E. coli 0157 Infections; Erlichiosis; InvasiveGroup A Strep Infections
OAAP 778 PLENARY SESSION PMChanges in the AAP Policy on Fetus &Newborn; Outcomes for Infants Who UndergoHeart Surgery; Literacy Promotion; Meet theRed Book Conunittee
O3AAP 779 (S325) Drug Profiling: How to DefendiYourself
O3AAP 7117 (S326) Withi Every Breath You Take:Environmental Healthi Problems
O3AAP 7114 (S327n Gait Problemn Look-alikesO3AAP 780 (S328) Practical Management of ADHD
in the OfficeOAAP 783 (F337) Group B Strep: Managemnent After
Maternal Prophylaxis...l1 cassette, $11O3AAP 782 (F339) Seven Herbs Every Pediatrician
Should Know...1 cassette, $11OAAP 7113 (H321) Section on Adolescent Health-
Practical Aspects of Adolescent CareHematuria, Proteinuria and Nephritis in theAdolescent; Psychopharmacology of AdolescentAttention and Mood Disorders; Coding andReimbursemnent of Adolescent Health Care...3 cassettes, $33
OAAP 777 (H24) Section on Pulmonology-Soothing Sounds from New Orleans: New Ideasin Chest DiseaseSnoring and Sleep Disorders; Croup: TheLatest in Treatment; New Inhaled Steroids inAsthma; Evaluation of Airway Difficulties(Congenital); Bronchiolitis: Fresh Ideas onTreatment; Parapneumonic Effussion...3 cassettes, $332
O3AAP 784 PLENAR SESSION AMGenetic Basis of Congenital Heart Disease;Asthma: Antileukotrients; EnvironmentalHazards; Food Allergic Reactions; Antenataland Postnatal Evaluation of UrologicalMalformations; Back to Sleep; SIDS Update by(ipper Gore)
O3AAP 785 (S401) Funny Shaped Heads: Is ItSerious? What's a Pediatrician to Do?
O3AAP 786 (S402) Dermatologic Manifestations ofInfectious Diseases
O3AAP 788 (F410) The Pediatrician's Role inPreventing Adult Heart Disease (The BogalusaHeart Study)...1 cassette, $11
O3AAP 789 (411) STDs and Related Conceems of theOlder Adolescent Male...l1 cassette, Sll
O3AAP790 413) Ingliinal Masses-Hernia,Hydrocele, Undescended Testes...1 casette, $11
O3AAP 792 (1?414) Dentistry for te Pediatrician...I cassette, $11
O3AAP 791 (1?438/F440) Psychopharmacology in theAdolescent...1 cassette, $11
O3AAP 793 (1?415) The New Neuarodiagnostic TestsWhen Are They Needed?...1 cassette, $11
O3AAP 794 PLENARY SESSION PMSchool Health Programs in Adolescent RiskBehaviors; Children Who Smoke; TeenAbsenteeism, School Dropout Behavior;Concussions in Sports; Sudden Death in Sports;
Status Epilepticus; Diabetes Control Compli-cations; Dietary Calcium
O3AAP 795 (S431) Office Approach to CommonHematological Problemns
[3AA 7118 (S439) Conunon Problemns in PediatricOrthopaedics
O3AAP 799 (1?424) After-Hour Phone Calls: NewTechnologies, New Solutions...1I cssette, $11
O3AAP 798 (F425) Office Strategies for thePediatrician Dealing withi Teen TobaccoAddiction...l1 cassette, $11
O3AAP 796 (X?426) Preparing a Child for ForeignTravel ...1 cassette, $11
O3AAP 797 (Fr427/F428) Enuresis: A PracticalApproach to Evaluation and Managemnent ofBed Wetters Over Six Years Old...1 cassette, $11
O3AAP 7100 (1?429) Neonatal Seizures...1 cassette, $11
OAAP 7101 PLENARY SESSION AMNewborn's hnnlogic nmnaturity;Cocaine Exposed Inat; InternationalAdoption; Sleep in Childhood; Developmen-tal Dysplasia of the Hip (DDH); NicotineAddiction
O3AAP 7102 (S501) Early Detection ofDevelopmental Delay
OAAP 7103 (S502) Conunon Nutritional Problemsin Children
O3AAP 7104 (FS07) Sexual Identity Confusion inAdolescents....l cassette, $11
O3AAP 7105 (FSIO) The Outpatient Treatmnent ofBurns ...1 cassette, $11
O3AAP 7106 (1?512) What to Do When Kids Say"No"...1 casette, Sll
OAAP 7107PLENARY SESSION PMUrinary Tract Infections of Febrile Infants;Dating Skin Traumna; Syncope; Update onAnti-Inflammatory Medication; RotavirusVaccine; TB Skin Testing in the Office;Rational Use of CT
OAAP 7108 (F515) Overuse Injury in ImmatureAthletes ...1 cassette, Sll
OAAP 7109 (FS16/FS17) Give It a Shot: Assessmentof nu aIoN Practices in the Office...1 cassette, $11
O3AAP 7115 (FS18) Preventive Healthi Care Issues inTeens ...1csette, $11
O3AAP 7110 (F521) Massage Therapy for Infants andChildren...l cassette, $11
32 AAP News January 1998
~~~~~~ ~~~~~~~~~~~~~~~n ~ ~ ~~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~~ ~ ~~~ ~ ~~~ ~ ~~~ ~ ~~~ ~ ~~~~~~~~~~~~ ~~~~ ~~~ ~ ~~ ~ ~~~ ~ ~~ ~ ~~ ~ ~~ ~~~ ~~~ ~~~ ~~~ ~~~ ~~~ ~~~ ~~~ ~~~~~~~~~ ~~~ ~~~ ~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~t-
I iC di:--D: K- -1 - Iv v \ . } . X L A ~\ s4gASt_ \ f _F ~~-- -K
Dear Academy Fellow:In order to fulfill the admission requirements of AAP Bylaws, you are requested to:1) carefully review the following list of new applicants forAcademy membership; and relay your reactions directyto your District Chairperson, whose name and address is at the end of this list.
In submitting these names of board-certified pediatricians to you, it is understood that academic and pediatric cre-dentials are not in question. Comments are requested concerning possible legal and/or ethical situations of whichyou might have personal knowledge.Send any comments on the following list of new applicants to your Distnct Chairperson by February 15.
New York 3
Giuseppina Benincasa, M.D.696 Haverstraw Rd.Suffern, NY 10901-2726
Mary T. Cosgrove, D.O0.20 Riverview PlaceHastings-on-Hudson, NY 10706
Lynnette Culanculan Cukaj, M.D.502 Chelsea Cove Dr., SouthHopewell Jct.,NY 15233
Kishwar Iqbal Dhingra, M.D.2 Colonial Rd.Scarsdale, NY 10583-7710
David Feingold, M.D.696 Haverstraw Rd.Montebello, NY 10901
Maria-Angela Fusi, M.D.211 W. 56th St.,#24-HNewYork,NY 10019
Lisa F. Imundo, M.D.Columbia Pres. Medical Center3959 Broadway, BH 106NNewYork,NY 10032
Viciki Bettina Peters, M.D.Mt. Sinai HospitalPediatrics, Box 1198NewYork,NY 10029
Barbara Kathryn Russell, D.O.188 E. 76th St., #7-CNew York,NY 10021-2828
Karen L. Warman, M.D.170 E. 77th St., #8ENew York, NY 10021-1919
New JerseyLorieta Hernandez Bogdan, M.D.20 Ludlow Ave.Spring Lake, NJ 07762-1563
Francis Njeuma Mase, M.D.1586 Shadybrook Rd.Wilmington, DE 19803-4000
Nkem Vesta Nnaeto, M.D.84 Sanford St.East Orange, NJ 07960
Hanan A. Tanuos, M.D.43 Heritage Dr.East Hanover, NJ 07936-3929
PennsylvaniaChristopher J. Festa, M.D.18 Furlong Dr.Cherry Hill, NJ 08003
Jill A. Foster, M.D.Alleghany Univ. Hospital, MCP3300 Henry Ave.Philadelphia, PA 19129
Lauri Ellen Spencer Paloni, M.D.102 Gwynmont Dr.North Wales, PA 19454-1813
George J. Vilushis, D.O.5729 Larchmont Dr.Erie, PA 16509-2917
Emergency MedicineSpecialty FellowMeta Loren Podrazik, M.D.221 S. 1 2th St., #406-SouthPhiladelphia, PA 19107
Otolaryngology Specialty FellowGary David Josephson, M.D.Div. of Ped. OT/Dept. of OTD-48 ACC East Bldg., #306P.O. Box 016960Miami, FL 33101
GeorgiaRichard Gonzalez, M.D.3997 Lawrenceville Hwy., 230BLilburn, GA 30247
Thomas Edward Mellow, M.D.1019-N Oak Chase Dr.Tucker, GA 30084
Neil R. Nickelson, D.O.Bi-County Gwinnett Pediatrics976 Killian Hill Rd.Lilburn, GA 30247
KentuckyJennifer Sevier Riebel, M.D.Georgetown Pediatrics1162 Lexington Rd.Georgetown, KY 40324-9392
Patrica MaschnerThompson, M.D.4192 Heartwood Dr.Lexington, KY 40515
North Carolina
Anshu Batra, M.D.20 Copper Hill Ct.Durham, NC 27713-9447
Dean R. Meisel, M.D.8108-B Market St.Wilmington, NC 28405
South Carolina
Anne Damayanthi Fernando, M.D.81 Coach Rd.Cheraw, SC 29520-9559
Tennessee
Jerry Brooksher Gee, II, M.D.Univ. of Tenn. - MemphisDiv. of Newborn Medicine853 Jefferson Ave.Memphis,TN 38163
Gail Juanita Gossett, M.D.729 N. AvalonMemphis,TN 38107
Ralph Michael Green, M.D.613 Laurel Valley Dr.Knoxville, TN 37922-1522
Virginia
Seirin Barmada-Mazid, M.D.2101 Polo Pointe Dr.Vienna,VA 22181
Mary Bernardi Edelson, M.D.4926 Bromley LaneRichmond, VA 23226-1235
Diane R. Jacobsohn, M.D.1303 N. Ode St., #202Arlington, VA 22209
Surgery Specialty FellowRobert Edward Kelly, Jr., M.D.
*P.O. Box 11267.Norfolk,VA 23517
Abdullah T.S. Al-Turki, M.D.King Faisal Specialist HospitalPediatrics, MBC58P.O. Box 3354Riyadh, 11211Saudi Arabia
Indiana
Jeffrey Rogers Leipzig, M.D.3519 Tahoe Rd.Carmel, IN 46033
MichiganKenneth J. Fawcett, Jr., M.D.4829 E. Beltline, NE, #201Grand Rapids, MI 49505
Tarek Garada, M.D.29768 Citation Circle, #32205Farmington, MI 48331 -5896
Margaret A. Morath, D.O.B-545 W. Fee HallEast Lansing, Ml 48824
Surgery Specialty FellowJoseph Lawrence Lelli, Jr., M.D.Pediatric Surgical Assoc.F3970 Mott Children's HospitalAnn Arbor, MI 48109-0245
Ohio
Samar Haddad Bashour, M.D.2047 Farmington TurnWestlake, OH 44145-2944
Randal S. Olshefski, M.D.Columbus Children's Hospital700 Children's Dr., H/O SectionColumbus, OH 43205-2696
Angela Rambalakos Pecha, M.D.1305 Grace Ave.Cincinnati, OH 45208-2427
Alla Sherman, M.D.679 Davidson Dr.Highland Heights, OH 44143
Sheila Kay Sturgill, M.D.5170 Darrow Rd.Hudson, OH 44236
Uniformed Services East
Lisa Georgianne Rider, M.D.3104 Homewood Pkwy.Kensington, MD 20895
Ophthalmology Specialty FellowRobert Bryson North, Jr., D.O.895 Tylerton CircleGrayslake, IL 60030
Massachusetts
George LaMonte Askew, M.D.42 Stoney Run LaneMarion, MA 02738-1218
Kimberlee Fish Chatson, M.D.21 Royal Crest Dr., #10North Andover,MA 01845
Michael Gerard D'Alessandro, M.D.325 River Rd.South Hadley, MA 01075
Maria Adriana Schoen, M.D.16 Grove St., Apt. #1Westborough, MA 01581
Alabama
Bhagwan Das Bang, M.D.301 2nd Ave.Audalusia, AL 36420
Arkansas
Maria Teresa Esquivel, M.D.13916 Saddle Hill Dr.Little Rock, AR 72212
,Louisiana
*Bedford Nieves-Cruz, M.D.P.O. Box 5035Houma, LA 70361
Sheila G. Pitre, M.D.807 Ridgefield Rd.Thibodaux, LA 70301-3901
*Raymond Cachopero Poliquit, M.D.*.Delta Rural Health Services804 Beech St.P.O. Box 1528Tallulah, LA 71284-1528
.Mississippi*Dennis John Hey, D.O.1314 19th Ave.
,Meridian, MS 39301-4116
*.Texas
Kevin Lawrence Berger, M.D.2421 Southgate Blvd.
*Houston, TX 77030
Florida
Jack William Bandel, M.D.3400 NE 192nd St., Apt. 1003North Miami Beach, FL 33180
Shirley Cambell-Mogg, M.D.10710 NW 18th Ct.Plantation, FL 33322-6476
Stewart Aubrey Grant, M.D.1608 Harvard Woods Dr., #2604Brandon, FL 33511
Dewitt Benjamin Helgemo, M.D.26419 Lancer LanePunta Gorda, FL 33983
Dorlinda Varga House, M.D.3048 Alatka Ct.Longwood, FL 32779
Marc Yves-Rene Linares, M.D.11101 S.W. 71st Ave.Miami, FL 33156-3945
Ella J. Marsh, D.O.8210 Imber St.Orlando, FL 32825
Alex M. Uson, M.D.615 W. Dixie Ave.Leesburg, FL 34748
New York 1
Nader Henry Atallah-Yunes, M.D.683 E. Seneca Turnpike, #13-19Syracuse, NY 13205-2621
Noel Benitez Rosales, M.D.Crouse Pediatrics600 E. Genesee St., #217Syracuse, NY 13202
NewYork2
Mary Cappuccino Bonafede, M.D.2 Larry LaneWest Islip, NY 11795
Robert Stephen Darr, M.D.356 76th St.Brooklyn, NY 11209
Adolfo F. Grieg, D.O.1 19 Cayuga PlaceJericho,NY 11753
Pradeep Kumar Kandula, M.D.2650 Ocean Parkway, #6FBrooklyn, NY 11235
Mario J. LiPera, M.D.61 Willets Rd.Old Westbury, NY 11568
11
_ _~Wl
___r~~~~~~~~~~~~~~~~
January 1998 AA8P Neovjs 33
Minnesota
Andrea Marie Janousek, M.D.4445 Chatsworth St., N.Shoreview,MN 55126
Deborah Simson Nicholson, M.D.7508 Hyde Park Dr.Edina,MN 55439-1743
Missouri
Diane Mary Eschmann, M.D.13303 Tesson Ferry Rd., #50St. Louis, MO 63128
Catherine Ruth Remus, M.D.727 RadcliffeSt. Louis, MO 63130
Nebraska
Mark Richard Corkins, M.D.600 S. 42nd StreetBox 985160Omaha, NE 68198-5160
Wisconsin
Jeanine Marie Swenson, M.D.Mercy Regional Heart Center1000 Mineral Point Ave.Janesville, WI 53545
District of Columbia
Amelia Barranda Bautista, M.D.825 New Hampshire Ave., NW,#109Washington, DC 20037
Deleware
Ophthalmology Specialty FellowJane Covington Edmond, M.D.duPont Hospital for ChildrenDept. of Surgery1600 Rockland Rd., P.O. Box 269Wilmington, DE 19899
MarylandChristine Leila Saba, M.D.9021 Wandering Trail Dr.Potomac, MD 20854
Robert P. Wack, M.D.93 W. Green St.Westminster, MD 21157
British Columbia
Carl L. Ivey, M.D.377 Carneghe St.Campbell River, BC V9W 2J14Canada
Illinois
Hassan Alzein, M.D.10522 S. Cicero Ave., #4-DOak Lawn, IL 60453
Jonette Pangilinan Belicena, M.D.10231 S. Central Ave., #3DOak Lawn, IL 60453-4664
John W. Graneto, D.O.498 W. Belmont Ave.Chicago, IL 60657
Gwenn S. O'Keeffe, M.D.36649 N. Old Woods TrailGurnee, IL 60031
Mwk.~_S
,e- WW
Murad M. Dharani, M.D.515 S. Sugar Rd., #10Edinburg, TX 78539
Monica Herrera, M.D.1409 Pagewynne Dr.Piano, TX 75093-2633
Peter William Hine, M.D.3724 Indian Point Dr.Austin, TX 78739
Hasina Hussain, M.D.101 Sand Point Ct.Coppell,TX 75019-5359
Anesthesiology Specialty FellowJeffrey Michael Berman, M.D.UTMB, Anesthesiology301 Univ. Blvd., #2A, J.SealyGalveston, TX 77555-0591
Colorado
Deirdre Arnholz, M.D.1771 S. Quebec Way, #W202Denver, CO 80231
Ann-Christine Nyquist, M.D.780 Krameria St.Denver, CO 80220-5355
Mark G. Roback, M.D.1228 Cook St.Denver, CO 80206
New Mexico
Stanley Dav/id HandmaJ<er, M.D., Ph.D.P.O. Box 1013Corrales, NM\ 87048
OregonCharles Edward Pntchard, D.O.1825 Maple St.Forest Grove, OR 97116
Utah
Carol Sue Bruggers, M.D.1 345 S. Yuma St.Salt Lake City, UT 84108-2258
Amy Stenback, M.D.2243 Via PraviaLa Jolla, CA 92037-5841
DISTRICT IV
E. Stephen Edwards, M.D.2800 Blue Ridge Blvd.Suite 501Raleigh, NC 27607-6496
DISTRICT V
Stanford A. Singer, M.D.16800 W. Twelve Mile Rd.Suite 205Southfield, MI 48076-2138
DISTRICT VI
Ordean Torstenson, M.D.1313 Fish Hatchery Rd.Madison,WI 53715
DISTRICT VIl
Carden Johnston, M.D.Children's Hospital of Alabama1600 7th Ave., SouthSuite 001Birmingham, AL 35233-1711
DISTRICT VIII
Donald E. Cook, M.D.The Monfort Children's Clinic947 First St.Greeley, CO 80631
DISTRICT IX
Lucy S. Crain, M.D.USCSF Box 0374400 Parnassus AvenueSan Francisco, CA 94143-0374
AmericanAcademy ofPediatrics
California 1
Diane Lynne Ching, M.D.369 Warren Dr.San Francisco, CA 94131 -1033
California 2
Lauren Ashforth Dimen, M.D.212 E. Foothill Blvd.Arcadia, CA 91006
Sharada Prasad MAenon, M.D.2800 Plaza Del Amo, #210Torrance, CA 90503-9312
Elliot Taketo Sumi, M.D.3440 Lomita Blvd., #144Torrance, CA 90505
Philip Russell Vaughn, M.D.2831 Pierpont Blvd.Ventura, CA 93001
California 3
George T. Koburov, M.D.3030 Children's Way, #104San Diego, CA 92123
DISTRICT I
Gilbert L. Fuld, M.D.The Hitchcock Clinic590 Court St.Keene, NH 03431-171 9
DISTRICT 11
Louis Z. Cooper, M.D.St. Lukes Roosevelt Hospital1000 Tenth Ave.New York,NY 10019
DISTRICT III
Susan Aronson, M.D.605 Moreno Rd.Narberth, PA 19072-161 8
Arizona
Juan Alberto Gutierrez, M.D.Univ. of Arizona, HSC, Pediatrics1501 N. Campbell Ave.Tucson, AZ 85724-5073
'A..
because life's challengingenough without a
bedwetting problem!
-~~~~6CA le
IDEAS FOR LIVING, INC. BOULDER, COLORADO 80304
34 -'I"N 7- ~i January 1998
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FOR COMPLETE I NFO: 800-497-6573 OR 303-440-851 7
( i3 .- -t)
MNED/PEDS * Double Boarded or eligible.|The Mid-Atlantic Permanente Medical Group, P.C., a physician owned andmanaged medical group, is growing and expanding our facilities in Virginia,Maryland, and Washington, D.C. We are seeking a top quality Physician withresidency training in both Internal Medicine and Pediatrics to provide excellentservice in our modern, state-of-the-art offices. Person would be expected toteach Resident Physicians in Georgetown University's/Kaiser Permanente'sMed/Peds 4 year program. Faculty appointment at Georgetown is required.Excellent salary and benefit package including vacation and sick time,health/life benefits, malpractice coverage, retirement, relocation allowance,shareholder opportunity, and much more. Very reasonable call schedule allowsfor predicable time off. Nationally recognized for quality care, KCaiserPermanente presents an ideal opportunity. To learn more about this ideal oppor-tunity, send/fax CV to:
Dorothy Houlihan,DDPhysician Recruitment, MLAPMG, ^2101 E. Jefferson Street, Box 6649, GTz
Rockhflle,MD 20849.E d1-800-227-6472. Fax301-816-7472. KAMJER PERMANENTE
FebruaryPediatric Potpourri (E: State of the Art 1998-Maui, Hawaii, Feb. 14-20,1998. Spon-sored by the University Children's MedicalGroup, AAP California Chapter 2 (DistrictIX). Contact: Laura Thomas, 6430 SunsetBlvd., Suite 600, Los Angeles, CA 90028;(800) 3-KID-CME.
8th Dartmouth Waterville conference:"Contemporary Issues in Office Pedi-atrics" -Feb. 26 - March 1, 1998,sponsored by the AAP New HampshireChapter and Children's Hospital at Dart-mouth. Contact: Kat Barton, N.H. PediatricSociety, 45 Lyme Road, Suite 304, Hanover,NH 03755; (603) 643-2325; fax (603)643-1444; e-mail cb4maOaol.com.
Department of Pediatrics, University ofSouth Florida College of Medicine -"Gulf Coast Pediatric Conference," HolidayInn Select Hotel, Ft. Myers, Fla. Feb. 27 and28, 1998. Credit: 10 hours AAMA-1. For fur-ther information, contact Rebecca Scott,(813) 272-2744; fax (813) 272-2749.
Mamh
Pediatrics Seminar "Advances andChanging Trends" (Ninth Annual LloydNoland) -at the Buena Vista Palace, WaltDisney World, Fla., March 18-21, 1998.Faculty: Drs. Duffner, Redding, Reiter, Ruleyand Treadwell. Call/write: George M.Converse, M.D., FAAP, Department ofMedical Education, Lloyd Noland Found-ation, P.O. Box 925, Fairfield, AL 35064;(205) 783-5276.
AprilPediatrics Update (Fifth Annual LloydNoland) -Hilton Head Island, S.C., April22-25,1998. Faculty: Drs. Howard, Senac,Smith, Stockman and Weston. Call/write:George M. Converse, M.D., FAAP, Depart-ment of Medical Education, Lloyd NolandFoundation, P.O. Box 925, Fairfield, AL35064 (205) 783-5276.
Washington, D.C.: 18th Annual NationalPediatric Infectious Disease Seminar-April 15-18, 1998, Grand Hyatt,Washington, D.C. The seminar is jointlysponsored by the University of TexasSouthwestern Medical Center at Dallas,Texas, the accrediting institution, and theNational Pediatric Infectious DiseasesFoundation. CME/AAP credit offered. Forinformation you may consult the Web site:http://www.cwiweb.com/npids or call(317) 578-3075; telefax (317) 578-3802.
June
Current Concepts in Pediatric RespiratoryDiseases-June 19-21, 1998. Sponsoredby Children's Hospital in cooperation withUniversity of California, San Diego. SanDiego Hilton Beach and Tennis Resort,San Diego, Calif. Contact: (619) 576-4072; fax (619) 974-6723; e-mailoholidayEchsd.org. CME and AAFPCredits: 16.
Pediatric Infectious Disease Seminar(Sixteenth Annual Lloyd Noland)-HiltonHead Island, S.C. June 23-27, 1998.Faculty: Drs. Church, Jacobs, McIntosh,Pickering and Shulman. Call/write: GeorgeM. Converse, M.D., FAAP, Departmentof Medical Education, Lloyd NolandFoundation, P.O. Box 925, Fairfield, AL35064 (205) 783-5276.
Colorado
BE/BC Pediatrician -to join a busy prac-tice in the Colorado foothills. 1:4 callschedule, practice conveniently locatednext to the hospital. Pleasant community of30,000-35,000. Fax resume to RogerNoland, (719) 269-1730.
Florida
Tampa: Pediatric Urgent Care-Staff anddirector positions available, full- or part-time in evenings and weekend/holidayclinics. Treatments include fracture andlaceration management, intravenousrehydration and prolonged asthma therapy.Contact After Hours Pediatrics, Inc., (813)404-2023.
Pediatrician Surgeon -One-in-threecall. $150,000 + all benefits + productiv-ity. Fax c.v.: Dr. Jacobs, (914) 833-171 1;voice (914) 833-1700; (800) 333-2999.REF: 6271.
Idaho
Boise -Board Certified/Board EligiblePediatrician to join busy pediatric practice inBoise. Guaranteed salary with partnershipopportunity. Beautiful location with easyaccess to wilderness, whitewater, snow ski-ing, hunting and fishing. The Pediatricand Adolescent Center, Bill Bourquard,M.D./Tom Tilden, M.D., (208) 322-5437;Palmer Morrow, administrator, (208) 381 -
1526. Will entertain inquires now.
Illinois
Chicago -Pediatrician: BE/BC needed inNorthwest Chicago. Fluent Polish speakingis very helpful. Phone (773) 725-5400; Fax(773) 725-4707 Maria Staisz, M.D., FAAP.
University of Illinois College of Medicine-Departments of Medicine and Pediatrics
seeks an Associate Program Director at theMedicine/Pediatrics Residency TeachingProgram. We are recruiting an inter-nist/pediatrician for this Associate ProgramDirector position. The selected individualwill have administrative responsibilities inour combined Medicine/Pediatrics resi-dency. The residency is with theUniversity of Illinois College of Medicine,located at St. Francis Medical Center, themajor health care provider for NorthCentral Illinois. Candidates must hold orbe eligible for Illinois medical license, beBC or BE in internal medicine and pedi-atrics, and eligible for appointment at theUniversity of Illinois College of Medicineat the rank of Instructor, Associate orAssistant Professor. Applicant must be apersonable and enthusiastic teacher whoenjoys patient care. If interested pleasecontact: Marie Noeth, 4541 N. Prospect,4th floor, Peoria, IL 61614; (800) 438-3745; fax (309) 685-2574; or emailmarie.noeth osfheaIthcare.com
KentuckyHazard Pediatrics -needs a pediatrician inHazard, Ky., in a fairly rural setting. All can-didates welcome to apply. Send reply toHazard Pediatrics, P.O. Box 2748, Pikeville,KY 41 502-2708.
Massachusetts
Greater Boston Area -Hospital affiliatedprimary care group practice seeks BC/BEfull-time pediatrician. Excellent compensa-tion package. Please send or fax c.v. to:President, Eastern Massachusetts HealthAssociates, Inc., Hope Ave., Waltham, MAA02254; fax (781 ) 647-6188.
ton, DC 20037. The George WashingtonUniversity is an affirmative action/equalopportunity employer.
New York and Connecticut
Pediatrician -Westchester County. To$140K. 1 in 7 call. Fax c.v. to: ValerieScheck (914) 833-171 1; voice (913) 833-1700; (800) 333-2999. REF: 6222c.
Washington, DC, Maryland and VirginiaSuburbs: Primary Care Pediatricians ae TheGeorge Washington University MedicalCenter is seeking primary care pediatriciansto join GW Primary Care Associates, a mul-tidisciplinary primary care group with officeson the Medical Center campus and inMaryland and Virginia suburbs. Qualifiedcandidates must be board certified in pedi-atrics (or board eligible if within two yearsof residency completion). Primary care andmanaged care experience desired. Selectedcandidates receive faculty appointmentsand participate in primary care educationalprograms as clinical preceptors. Excellentbenefits package includes opportunity foradvanced degree with tuition benefits.Applications accepted and reviewed on anongoing basis until each vacancy in thisacademic year is filled. Send c.v. and coverletter indicating interest in Washington,D.C., suburban Maryland and/or Virginia;full-time or part-time, to ElizabethCallender, MHSA, Executive Coordinator,GW Primary Care Associates, Room G-202,2150 Pennsylvania Ave., N.W., Washing-
Accewo the best in pediatrics...
New JerseyCentral New Jersey -25+ years estab-lished solo pediatric practice/office for sale.Average gross over $200,000.00 Respondto: AAP News, Box 090197, 141Northwest Point Blvd., Elk Grove Village,IL 60007.
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Whenyou need to contactpediatricians, contactAAPNews. Each month more than 53,000pediatricians,pediatricspecialists, third-yearpediatric residents and othersubscribers turn toAAPNewsforchild healthinformation theycannotget elsewhere. With a classified ad, you can speak directly to those readers.
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These advertising modifications are made to maintain a clas-sified section that is professionally responsible, lawful,scientific and free ofdiscrimination.
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Publication ofan advertisement inAAP News neither consti-tutes nor implies a guarantee or endorsement byAAP Newsor the AmericanAcademy ofPediatrics ofthe product or ser-vice advertised or of the claims made for the product orservice by the advertiser.
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January1998 AAPNews 35
Nebraska
Lincoln -Acute care, after hours pediatficclinic seeks BE/BC pediatrician. Clinic is hos-pital based, some emergency pediatrics isinvolved. Schedule allows time for personalpursuits. Good schools, low crime rate, cul-tural advantages of a university city. No J-1visa applications at this time. Contact StevePetruconis, (402) 486-7700, Saint ElizabethCommunity Health Center, 555 South70th, Lincoln, NE 68510.
North Carolina
FT or PT-Join group of four in family ori-ented community with more Fortune 500companies per population square mile thanany other county in the state! Competitivecompensation package, including resi-dency loans. Melisa Ciarrocca, (800)764-7497; fax (910) 291-7499; e-mail:mciarroccaOnconline.com.
PennsylvaniaPenn State Geisinger Health System -iscurrently seeking a BC/BE Pediatrician tojoin its multispecialty group pracffce in StateCollege, Penn. Join two other Pediatricphysicians in this busy medical practice. Callis shared with nearby sister clinic and is 1:5.Administrative opportunity available ifdesired. State College, located in the heartof Pennsylvania, is home to Penn StateUniversity. The area offers a tremendousamount of educational, cultural and recre-ational activities to enjoy. State Collegeprovides an excellent business climate andoffers a superior quality of life. We offer acompetitive salary and excellent benefitpackage. Foraddiffonal informaffon, pleasecontact: Penn State Geisinger ProfessionalStaffing (PD-AB), 100 North AcademyAve., Danville, PA 17822-1528. Phone(800) 845-7112; fax: (800) 622-2515.E.O.E. M/F/H/V.
VirginiaRichmond area -Part- /full-time BC/BEpediatrician for dynamic, growing practice.Competitive salary with eventual partner-ship. Hospitals with full service pediatrics,NICU, PICU. Attractive planned communi-ties. Excellent schools and recreationalfacilities. Nearby Medical College ofVirginia. Extremely light call. Send CV or callJudith F. McGhee, M.D., 4902 MillridgeParkway, MidlIothian, VA 231 12, (804)744-1231, orfAX (804) 744-9521.
CIHARGE ITYou can now charge yourAAPNeivs dasifiedadvertising costs on
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ciIL _;4nXr^|f7\I-
\_.f N;t\ t4l tD. 0.
fI -asW< I"; ^r
Ew ~THIS IS AN IMPORTANT EVENT:cixteen mi'll'ion children and adolescents eachSyear are rushed to emergency departmcrnts;
followinlg serious illness and injury. As a Congressparticipant, you will seek viable ways of ens-urinathese crit'ically ill and injured ch'ildren timely, qualityemergency care.
OF THE CONGRESS:* To Re-examine Pediatric Emergency Sei-lwces i'nthe Context of Changes to the Health Care System
* To Provide a Forum for the Very Latest inEMSC-related Research*To Showcase E-ffective and IlnnovativeCommunity ProgTams
- ~WILL JOIN YOU AT THE CONGRESS:ealt Professi'onals
*Health Care Administrators*Pol'icy Makers*Health Finance and Managed Care ProuvidersvConsumers*Volunteer and Communilty Advocates
SUBSCRIPTIONINFORMATIONSubscriptions toAAP?Newscost $40 for nornmembers.To subscribe, contact:
Pete Petersen,subscriptions anld advertising
coordinator at
1(800) 433-9016, ext. 7667.
Canadian Paediatric Soci&t canadienneSooiety de pediatrie
VO s New up North?Just ask the Canadian Paediatric society
The Canadian Paediatric Society (CPS), an organization of 2,000 paedia-tricians, is Canada's foremost resource on infant, child, and youth healthissues. For nearly 75 years, we have been advocating for Canada's kids.We produce national guidelines for paediatric care and practice, providecontinuing medical education for our members, and promote the inter-ests of Daediatricians. We are regularly consulted by other health careprofessionals, govemment, media, and the public.
An invitation to members of the American AcademyOf PediatricBecause child health has no borders, we're extending a special invitationto members of the American Academy of Pediatrics.You can keep up-to-date on advances, guidelines, and activities inCanadian paediatrics by joining the Canadian Paediatric Societ-y. We'vecreated a new membership category just for AAP members.You'll benefit from membership in the CPS
With your membershipf you'll receive:* subscription to Paediatrics & Child Health, the official CPS journal* subscription to the CPS News, our bimonthly newsletter* current clinical practice guidelines of the CPS* membership listYou'll also enjoy savings on our Annual Meeting and continuing medicaleducation courses.
Contact us for details:Canadian Paediatn'c Society * Membership Services
100-2204 Walkley Road * Ottawa, Ontario Kl G 4G8Tel. (613) 526-9397, ext. 238 * Fax: (613) 526-3332E-mail: membershipOcps.ca * Internet: www.cps.ca
(Formerly -the NatAonalI Mediia Lit~eracy GConference)Juneo Z8~-July 1, 100z3
"At4 Plaradligmt fo>r Public He3al-t;h"The health and well-being of our children. is dramatically influenced by images andmessages conveyed by the media. Professionals and parents have an enormous stake inguaranteeing that the media's influence on our nation's yoth be positive. This can beaccomplished through media education, which includes deovuelopment of critical thinkingand veigsil,adofrnceative alternatives to media consumption. If our nationis to reach its goal of having a%fealthier, more productive society in the next millennium,we must move media education into schools, romes and communities.
T O~T GET MORE INFORMATION:Please call the EMSC National Resource Centerat (202) 884-4927 or eniail [email protected] Ei-nergency Med'ical Services for Children(EMSC) progra'm focuses 'its energies on all aspectsof pediatric emergency care-from in'jurypreventi'on and prehospital servzices to care inthe emergency department, rehabililtation, andreintegration 'into the community. V'isit our websiteat www.emsc.com.
I
I
ITIe National Congress onChildhood Emergenc'ies:Communibt Partnersh'ins,Cri'tical Care and Policy
Sponsored by:Emergency MedicalServilces for ChildrenMarch 22-24, 1998Renaissance HotelWashington, DC
NA--IIONALCONGRESSON CHILDHOO0DlEME RGEN CI ES
Organized and Hosted by:p,M-
Par-tnershipfor MediaEducation
A Collaboration of:American Academy of Pediatrics
Center for Media LiteracyMedia Literacy Project at Clark Universitv
Center for Substance Abuse Prevention./SAMHMA
For mo>re informatiokn abo>ut~at;teding r presen.ting cont~act-:
Conference Office2121 South Oneida Street, Suite 325
Denver, CO 80224-2552
Ph: 303 756-8380 * Fax: 303 759-8861E-mail: NsMEC980aol.com
Web Site: www.ConferenceOffice.corn/NMEC
PEDIATRIC FACULTY CRITICAL CAREThe department of Pediatrics, University of Illinois College of Medicine at Peoria (UICOM-P) is offering a
full time position in Pediatric Critical Care at the Assistant Professor, Associate Professor or Professor level.Active regional outreach and transport system and cardiac surgery programs. Significant opportunities
exist for teaching, patient care, and clinical research.Must be Board certified or Board eligible in Pediatric Critical Care Medicine. Rank and Salary commen-
surate with prior experience and qualifications.The University of Illinois is an Affirmative Action/Equal Opportunity employer. Applications will be received
until a qualified applicant is identified. Position available immediately. Send Curriculum vitae and three let-ters of reference to:
G. Kris Bysani, M.D. * Director and Chief, Section of Pediatric Critical CareUniversity of Illinois College of Medicine at Peoria * Children's Hospital of Illinois
530 N.E. Glen Oak Avenue, Peoria, IL 61637 - Phone 1 -800-438-3745 or FAX 1 -309-685-2574
OSF"A commitment to lIffe.
PEDIATRIC PRACTICEOPPORTUNITY
A single-specialty group of sixPediatricians is seeking a BC Or BEpediatrician to join them in thenewly remodeled office buildingjust two miles from OSF SaintFrancis Medical Center in historicPeoria, Illinois. Beginning patientload is 20-25 per day, with twelveexam rooms, five nurses and fiveclerical support staff members.
This position will enable you tobecome part of the OSF MedicalGroup, a network of primary carephysicians affiliated with OSFHealthcare Systems. We offeracompetitive salary and an extensivebenefits package.Peoria is locatedalong the banks of thescenic Illinois River,and has a populationof 180,000. Formore_information pleasecontact:Wendy Bass iPhysician Recruiter(800)462-3621FAX (309)685-2574or E-mail:wendy.bassWosfhealthcare.com
EBY.EBY-MAILAAPNews can now accept yourclassified advertising by e-mail!Send ads to [email protected]
THE RIGHT CAREMfWHrE2N, IT COUNTS
ChildrerfsAsi06I| C The University of Illinois
College of Medicine at Peoria
Kitvi.01.1to*IMWi_mil t $UtL" __===AM-__ =o*vw'
Z'+h n@~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Ito(czithromycin tororulsuspension)~
ZITHROMAX°(azithromycin for oral suspension)
BRIEF SUMMARY
INDICATIONS AND USAGEZITHROMAX(¢ (azithromycin) is indicated for the treatment of patients with mild to moderate infections (pneumonia: seeWARNINGS) caused by susceptible strains of the designated microorganisms in the specific conditions listed below. Asrecommended dosages, durations of therapy, and applicable patient populations vary among these infections, please seeDOSAGE AND ADMINISTRATION for specific dosing recommendations.
Acute otitis media caused by Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae. (Forspecific dosage recommendation, see DOSAGE AND ADMINISTRATION.)
Community-acquired pneumonia due to Chlamydia pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae,or Streptococcus pneumoniae in patients appropriate for oral therapy. (For specific dosage recommendation, see DOSAGEAND ADMINISTRATION.)
NOTE: Azithromycin should not be used in pediatric patients with pneumonia who are judged to beinappropriate for oral therapy because of moderate to severe illness or risk factors such as any of thefollowing: patients with cystic fibrosis, patients with nosocomially acquired infections, patients withknown or suspected bacteremia, patients requiring hospitalization, or patients with significantunderlying health problems that may compromise their ability to respond to their illness (includingimmunodeficiency or functional asplenia).
Pharyngitis/tonsillitis caused by Streptococcuspyogenesas an alternative to first-line therapy in individuals whocannot use first-line therapy. (For specific dosage recommendations, see DOSAGE AND ADMINISTRATION.)
NOTE: Penicliin by the intramuscular route is the usual drug of choice in the treatment of Streptococcus pyogenesinfection and the prophylaxis of rheumatic fever. ZITHROMAXI is often effective in the eradication of susceptible strains ofStreptococcus pyogenes from the nasopharynx. Because some strains are resistant to ZITHROMAXO, susceptibility testsshould be performed when patients are treated with ZITHROMAX(0. Data establishing efficacy of azithromycin in subsequentprevention of rheumatic fever are not available.
Appropriate culture and susceptibility tests should be performed before treatment to determine the causative organismand its susceptibility to azithromycin. Therapy with ZITHROMAX(O may be initiated before results of these tests are known;once the results become available, antimicrobial therapy should be adjusted accordingly.
CONTRAINDICATIONSZITHROMAX( is contraindicated in patients with known hypersensitivity to azithromycin, erythromycin, or any macrolideantibiotic.
WARNINGSSerious allergic reactions, including angioedema, anaphylaxis, and dermatologic reactions including Stevens JohnsonSyndrome and toxic epidermal necrolysis have been reported rarely in patients on azithromycin therapy. Although rare,fatalities have been reported. (See CONTRAINDICATIONS.) Despite initially successful symptomatic treatment of theallergic symptoms, when symptomatic therapy was discontinued, the allergic symptoms recurred soon thereafter in somepatients without further azithromycin exposure. These patients required prolonged periods of observation andsymptomatic treatment. The relationship of these episodes to the long tissue half-life of azithromycin and subsequentprolonged exposure to antigen is unknown at present.
If an allergic reaction occurs, the drug should be discontinued and appropriate therapy should be instituted. Physiciansshould be aware that reappearance of the allergic symptoms may occur when symptomatic therapy is discontinued.
In the treatment of pneumonia, azithromycin has only been shown to be safe and effective in the treatinent ofcommunity-acquired pneumonia due to Chlamydia pneumonise, Haemophilus influenzae, Mycoplasmapneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy. Azithromycin should not beused in patients with pneumonia who are judged to be inappropriate for oral therapy because of moderate tosevere illness or risk factors such as any of the following: patients with cystic fibrosis, patients withnosocomially acquired infections, patients with known or suspected bacteremia, patients requiringhospitalization, elderly or debilitated patients, or patients with significant underlying health problems that maycompromise their ability to respond to their illness (including immunodeficiency or functional asplenia).
Pseudomembranous colitis has been reported with nearly all antibacterial agents and may range in severityfrom mild to life-threatening. Therefore, it is important to consider this diagnosis in patients who present withdiarrhea subsequent to the administration of antibacterial agents.
Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridia. Studiesindicate that a toxin produced by Clostridium difficile is a primary cause of "antibiotic-associated colitis."
After the diagnosis of pseudomembranous colitis has been established, therapeutic measures should be initiated. Mildcases of pseudomembranous colitis usually respond to discontinuation of the drug alone. In moderate to severe cases,consideration should be given to management with fluids and electrolytes, protein supplementation, and treatment with anantibacterial drug clinically effective against Clostridium difficile colitis.
PRECAUTIONSGeneral: Because azithromycin is principally eliminated via the liver, caution should be exercised when azithromycin isadministered to patients with impaired hepatic function.
There are no data regarding azithromycin usage in patients with renal impairment; thus, caution should be exercised whenprescribing azithromycin in these patients.
The following adverse events have not been reported in clinical trials with azithromycin, an azalide; however, they havebeen reported with macrolide products: ventricular arrhythmias, including ventricular tachycardia and torsades de pointes, inindividuals with prolonged QT intervals.
There has been a spontaneous report from the post-marketing experience of a patient with previous history of arrhythmiaswho experienced torsades de pointes and subsequent myocardial infarction following a course of azithromycin therapy.Information for Patients: Patients should be cautioned to take ZITHROMAX" suspension at least one hour prior to a mealor at least two hours after a meal. This medication should not be taken with food.
Patients should also be cautioned not to take aluminum- and magnesium-containing antacids and azithromycinsimultaneously.
The patient should be directed to discontinue azithromycin immediately and contact a physician if any signs of an allergicreaction occur.Drug Interactions: Aluminum- and magnesium-containing antacids reduce the peak serum levels (rate) but not the AUC(extent) of azithromycin absorption.
Administration of cimetidine (800 mg) two hours prior to azithromycin had no effect on azithromycin absorption.Azithromycin did not affect the plasma levels or pharmacokinetics of theophylline administered as a single intravenous
dose. The effect of azithromycin on the plasma levels or pharmacokinetics of theophylline administered in multiple dosesresulting in therapeutic steady-state levels of theophylline is not known. However, concurrent use of macrolides andtheophylline has been associated with increases in the serum concentrations of theophylline. Therefore, until further dataare available, prudent medical practice dictates careful monitoring of plasma theophylline levels in patients receivingazithromycin and theophylline concomitantly.
Azithromycin did not affect the prothrombin time response to a single dose of warfarin. However, prudent medicalpractice dictates careful monitoring of prothrombin time in all patients treated with azithromycin and warfarin concomitantly.Concurrent use of macrolides and warfarin in clinical practice has been associated with increased anticoagulant effects.
The following drug interactions have not been reported in clinical trials with azithromycin; however, no specific druginteraction studies have been performed to evaluate potential drug-drug interaction. Nonetheless, they have been observedwith macrolide products. Until further data are developed regarding drug interactions when azithromycin and these drugs areused concomitantly, careful monitoring of patients is advised:
Digoxin-elevated digoxin levels.Ergotamine or dihydroergotamine-acute ergot toxicity characterized by severe peripheral vasospasm and dysesthesia.Triazolam-decrease the clearance of triazolam and thus may increase the pharmacologic effect of triazolam.Drugs metabolized by the cytochrome P450 system-elevations of serum carbamazepine, terfenadine, cyclosporine,hexobarbital, and phenytoin levels.
Laboratory Test Interactions: There are no reported laboratory test interactions.Carcinogenesis, Mutagenesis, Impairment of Fertility: Long-term studies in animals have not been performed toevaluate carcinogenic potential. Azithromycin has shown no mutagenic potential in standard laboratory tests: mouselymphoma assay, human lymphocyte clastogenic assay, and mouse bone marrow clastogenic assay. No evidence of impairedfertility due to azithromycin was found.
References: 1. Data on file. Pfizer Inc, New York, NY. 2. McLinn S, Williams D. High incidence ofStreptococcus pneumoniae and Haemophilus influenzae (beta-lactamase) resistance in recent otitis mediaclinical trial isolates. Presented at the 35th Interscience Conference on Antimicrobial Agents andChemotherapy; September 17-20, 1995; San Francisco, Calif. Abstract. 3. Hardy DJ, Hensey DM, BeyerJM, Vojtko C, McDonald EJ, Fernandes PB. Comparative in vitro activities of new 14-, 15-, and 16-membered macrolides. Antimicrob Agents Chemother. 1988;32:1710-1719. 4. Retsema J, Girard A,Schelkly W, et al. Spectrum and mode of action of azithromycin (CP-62,993), a new 15-membered-ringmacrolide with improved potency against gram-negative organisms. Antimicrob Agents Chemother.1987;31:1939-1947. 5. McLinn S. Double blind and ore label studies of azithromycin in themanagement of acute otitis media in children: a review. Pediatr Infect DisJ. 1995;14:S62-S66.6. Khurana C, McLinn S, Block S, Pichichero M. Trial of azithromycin (AZ) vs Augmentin (AUG) fortreatment of acute otitis media (AOM). Presented at the 34th Interscience Conference on AntimicrobialAgents and Chemotherapy; October 4-7, 1994; Orlando, Fla. Abstract.
Augmentin (amoxicillin/clavulanate potassium) is a registered trademark of SmithKline BeechamPharmaceuticals
Pregnancy: Teratogenic Effects. Pregnancy Category B: Reproduction studies have been performed in rats and mice atdoses up to moderately maternally toxic dose levels lie,200 mgtkg/day). These doses, based on a mg/m2 basis, areestimated to be 4 and 2 times, respectively, the human daily dose of 500 mg. In the animal studies, no evidence of harm tothe fetus due to azithromycin was found. There are, however, no adequate and well-controlled studies in pregnant women.Because animal reproduction studies are not always predictive of human response, azithromycin should be used duringpregnancy only if clearly needed.Nursing Mothers: It is not known whether azithromycin is excreted in human milk. Because many drugs are excreted inhuman milk, caution should be exercised when azithromycin is administered to a nursing woman.Pediatric Use: (INDICATIONS AND USAGE.)
Acute Otitis Media (dosage regimen: 10 mg/kg on Day 1 followed by 5 mg/kg on Days 2-5): Safety and effectiveness inthe treatment of children with otitis media under 6 months of age have not been established.
Community-Acquired Pneumonia (dosage regimen: 10 mg/kg on Day 1 followed by 5 mg/kg on Days 2-5): Safety andeffectiveness in the treatment of children with community-acquired pneumonia under 6 months of age have not beenestablished. Safety and effectiveness for pneumonia due to Chlamydia pneumoniae and Mycoplasma pneumoniae weredocumented in pediatric clinical trials. Safety and effectiveness for pneumonia due to Haemophilus influenzae andStreptococcus pneumoniae were not documented bacteriologically in the pediatric clinical trial due to difficulty in obtainingspecimens. Use of azithromycin for these two microorganisms is supported, however, by evidence from adequate and well-controlled studies in adults.
Pharyngitis/Tonsillitis (dosage regimen: 12 mg/kg on Days 1-5): Safety and effectiveness in the treatment of children withpharyngitis/tonsillitis under 2 years of age have not been established.
Studies evaluating the use of repeated courses of therapy have not been conducted.Geriatric Use: Pharmacokinetic parameters in older volunteers (65-85 years old) were similar to those in younger volunteers(18-40 years old) for the 5-day therapeutic regimen. Dosage adjustment does not appear to be necessary for older patientswith normal renal and hepatic function receiving treatment with this dosage regimen.
ADVERSE REACTIONSIn clinical trials, most of the reported side effects were mild to moderate in severity anid were reversible upondiscontinuation of the drug. Approximately 0.7% of the patients (adults and children) from the multiple-dose clinical trialsdiscontinued ZITHROMAXI, (azithromycin) therapy because of treatment-related side effects. Most of the side effectsleading to discontinuation were related to the gastrointestinal tract, e.g., nausea, vomiting, diarrhea, or abdominal pain.Potentially serious side effects of angioedema and cholestatic jaundice were reported rarely.Clinical: Adults: Multiple-dose regimen: Overall, the most common side effects in adult patients receiving a multiple-doseregimen of ZITHROMAXO were related to the gastrointestinal system with diarrhea/loose stools (5%), nausea (3%), andabdominal pain (3%) being the most frequently reported.
No other side effects occurred in patients on the multiple-dose regimen of ZITHROMAXI with a frequency greater than1%. Side effects that occurred with a frequency of 1% or less included the following:Cardiovascular: Palpitations, chest pain.Gastrointestinal: Dyspepsia, flatulence, vomiting, melena, and cholestatic jaundice.Genitourinary: Monilia, vaginitis, and nephritis.Nervous System: Dizziness, headache, vertigo, and somnolence.General: Fatigue.Allergic: Rash, photosensitivity, and angioedema.Single 1-gram dose regimen: Overall, the most common side effects in patients receiving a single-dose regimen of1 gram of ZITHROMAXI were related to the gastrointestinal system and were more frequently reported than in patientsreceiving the multiple-dose regimen.
Side effects that occurred in patients on the single one-gram dosing regimen of ZITHROMAXI with a frequency of 1% orgreater included diarrhea/loose stools (7%), nausea (5%), abdominal pain (5%), vomiting (2%), dyspepsia (1 %), and vaginitis(1 %).Single 2-gram dose regimen: Overall, the most common side effects in patients receiving a single 2-gram dose ofZITHROMAXO were related to the gastrointestinal system. Side effects that occurred in patients in this study with afrequency of 1% or greater included nausea (18%), diarrhea/loose stools (14%), vomiting 17%), abdominal pain (7%),vaginitis (2%), dyspepsia (1%), and dizziness (1 %). The majority of these complaints were mild in nature.Children: Multiple-dose regimens. The types of side effects in children were comparable to those seen in adults, withdifferent incidence rates for the two dosage regimens recommended in children.
Acute Otitis Media: For the recommended dosage regimen of 10 mg/kg on Day 1 followed by 5 mg/kg on Days 2-5, themost frequent side effects attributed to treatment were diarrhea/loose stools (2%), abdominal pain (2%), vomiting (1%), andnausea 1 %).
Community-Acquired Pneumonia: For the recommended dosage regimen of 10 mg/kg on Day 1 followed by 5 mg/kg onDays 2-5, the most frequent side effects attributed to treatment were diarrhea/loose stools (5.8%), abdominal pain, vomiting,and nausea 01.9% each), and rash 01.6%).
Pharyngitis/tonsillitis: For the recommended dosage regimen of 12 mg/kg on Days 1-5, the most frequent side effectsattributed to treatment were diarrhea/loose stools (6%), vomiting (5%), abdominal pain (3%), nausea (2%), andheadache 1 %).
With either treatment regimen, no other side effects occurred in children treated with ZITHROMAXO with a frequency ofgreater than 1%. Side effects that occurred with a frequency of 1% or less included the following:Cardiovascular: Chest pain.Gastrointestinal: Dyspepsia, constipation, anorexia, flatulence, and gastritis.Nervous System: Headache (otitis media dosage), hyperkinesia, dizziness, agitation, nervousness, insomnia.General: Fever, fatigue, malaise.Allergic: Rash.Skin and Appendages: Pruritus, urticaria.Special Senses: Conjunctivitis.Post-Marketing Experience: Adverse events reported with azithromycin during the post-marketing period in adult and/orpediatric patients for which a causal relationship may not be established include:Allergic: Arthralgia, edema, urticaria.Cardiovascular: Arrhythmias including ventricular tachycardia.Gastrointestinal: Anorexia, constipation, dyspepsia, flatulence, vomiting/diarrhea rarely resulting in dehydration.General: Asthenia, paresthesia.Genitourinary: Interstitial nephritis and acute renal failure.Liver/Biliary: Abnormal liver function including hepatitis and cholestatic jaundice.Nervous System: Convulsions.Skin/Appendages: Rarely serious skin reactions including erythema multiforme, Stevens Johnson Syndrome, and toxicepidermal necrolysis.Special Senses: Hearing disturbances including hearing loss, deafness, and/or tinnitus, rare reports of taste disturbances.Laboratory Abnormalities: Adults: Significant abnormalities (irrespective of drug relationship) occurring during the clinicaltrials were reported as follows: with an incidence of 1-2%, elevated serum creatine phosphokinase, potassium, ALT (SGPT),GGT, and AST (SGOT); with an incidence of less than 1%, leukopenia, neutropenia, decreased platelet count, elevated serumalkaline phosphatase, bilirubin, BUN, creatinine, blood glucose, LDH, and phosphate.
When follow-up was provided, changes in laboratory tests appeared to be reversible.In multiple-dose clinical trials involving more than 3000 patients, 3 patients discontinued therapy because of treatment-
related liver enzyme abnormalities and 1 because of a renal function abnormality.Children: Significant abnormalities (irrespective of drug relationship) occurring during clinical trials were all reported at afrequency of less than 1%, but were similar in type to the adult pattern.
DOSAGE AND ADMINISTRATION (See INDICATIONS AND USAGE.)Acute Otifis Media and Community-Acquired Pneumonia: The recommended dose of ZITHROMAXO for oral suspensionfor the treatment of children with acute otitis media and community-acquired pneumonia is 10 mg/kg as a single dose on thefirst day (not to exceed 500 mg/day) followed by 5 mg/kg on days 2 through 5 (not to exceed 250 mg/day).Pharyngitisw7onsillitis: The recommended dose for children with pharyngitis/tonsillitis is 12 mg/kg once a day for 5 days(not to exceed 500 mg/day).ZlTHROMAX'* for oral suspension should be given at least I hour before or 2 hours after a meal.ZITllROMA)(° for oral suspension should not be taken with food.
IMore detailed professional information available on request.Revised January 1997
3A97 0 U.S. PharmaceuticalsZC17E()1997, Pfizer Inc
The antibiotic solutionwith predictable results in
unpredi"ctable patients
Predictable Coverage of
Key Pathogens:H influenzae, S pneumoniae, and
M4 catarrhalis 1-4
Predictable Results:Proven as effective as
Aulgrentin0l ,5,6+
Predictable Convenience:The only 5-day, once-daily
treat-rnent
Predic-tably VWell Tolertd
Only 0.3% discont'inuatiLon dueto side effects
The most frequent side effects are
diarrhea/loose stools (2%), abdominal pain (2%),vomiting (1%), and nausea (1%). Zithromaes
(azithromycin) is contraindicated in patients withknown hypersensitivity to azithromycin,erythromycin, or any macrolide antibiotic.
THE PREDICTABILITY YOU N EED I N PEDIATRICS 0
THE ONLY 5-D.AY ,
O1NCE~DIkLY THERAkPYFR A4lCUTE OTITIS
MEDIAT