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TRANSCRIPT
NEVV FELLOVVSDear Academy Fellow:In order to fulfill the admission requirements of AAP Bylaws, you are requested to:Carefully review the following list of new Fellows for Academy membership; and relay yourreactions directly to your District Chairperson, whose name and address is at the end of this
list. In submifting these names of board-certified pediatricians to you, it is understood thatacademic and pediatric'credentials are not in question. Comments are requested concerningpossible legal and/or ethical situations which you might have personal knowledge.Send any comments on the following list of new Fellows to your District Chairperson.
New York 1
Richard Alling, M.D., FAAPCanandaigua, NY 14424-1728
Uzma Mehr, M.D., FAAPHornell, NY 14843-1003
Philip Rem'llard, M.D., FAAPLiverpool, NY 13090
Sania Wilkins, D.O., FAAPSyracuse, NY 13224
New York 2
Adeola Ayodeji, M.D., FAAPCarmel, NY 10512-5004
Deborah Brant-Deitch,M.D., FAAPRoslyn, NY 11576-1506
Joseph Cohen, M.D., FAAPBrooklyn, NY 11235-2301
Amy Goldberg, M.D., FAAPNew York, NY 1001 6
Mahmoud Hassanein,M.D., FAAPBrooklyn, NY 11209-6810
Erik Langenau, D'O., FAAPBrooklyn, NY 11234-4501
Tracy Lee, M.D., FAAPMineola, NY 11501-2302
Philip Pasternak, M.D., FAAPBronx, NY 10463-1246
Joni Scheidt, M.D., FAAPForest Hills, NY 1 1 375-5106
Syrgery Specialty FellowK-1chard Scriven, M.D., FAAPStony Brook, NY 1 1 794
Neurology Specialty FellowAkila Venkataraman,M.D., FAAPBrooklyn, NY 1 1 220-2429
Jason Wu, M.D., Ph.D., FAAPBrooklyn, NY .1 120-4233
Peywen Wu, M.D., FAAPRoslyn, NY 1 1 576
New York 3
Janeene Gordon, M.D., FAAPSloatsburg, NY 10974-1613
Seth Ness, M.D., FAAPNew York, NY 10029-7219
Vicki Porges, M.D., FAAPNew York, NY 1001 6
Andrew Satran, M.D., FAAPPomona, NY 10970
MarylandSha Avhree Buckman,M.D., FAAPWheaton, MD 20902
Gayle Fischer, M.D., FAAPBethesda, MD 20814-4235
Sanjay Jain, M.D., FAAPBaltimore, MD 21210
Kassandra Merker, M.D., FAAPGaithersburg, MD 20878-2263
Julie Yeh, M.D., FAAPBaltimore, MD 21209-4203
New JerseyAlison Cessario, M.D., FAAPSummit, NJ 07901-2571
Abdulla Al-Kaabi, M.D., FAAPDohaQatar
Girish Chandrashekharaiah,M.B.B.S., FAAPBangalore Karnataka 560076India
Andrew Kiboneka, M.D., FAAPKampalaUgandaStephane Paulus, M.D., FAAPBlantyre 3Malawi
Waltraud Saftler-Ertl,M.D., FAAPVienna Al 060Austria
Connecticut
Gretchen Crist, M.D., FAAPGreenwich, CT 06831
Errol Douglas, M.D., FAAPHartford, CT 06105-1210
Jonathan Sollinger, M.D., FAAPWestport, CT 06880
Maine
Stephen Donnelly, D.O., FAAPScarboro.ugh, ME 04074-9031
Kimberly MacDonald,M.D., FAAPFreeport, ME 04032-1305
Massachusefts
Kerri Benneft, M.D., FAAPNorth Andover, MA 01 845
Matthew Benz, M.D., FAAPSouthboro, MA 01 772
Michael Eikort, M.D., FAAPNewton, MA 02462
Michelle Jones, M.D., FAAPSwampscoft, MA 01 907
Laura Koweek, M.D., FAAPBoston, MA 02116
Nina Sand, M.D., FAAPNewton, MA 02458-1326
Uniformed Services-East
Pamela Limb, M.D., FAAPNew Bern, NC 28562
Erich Maul, D.O., FAAPBiloxi, MS 39531-6134
James Rick, M.D., FAAPOcean Springs, MS39564-5936-
Sarah Ryan, M.D., FAAPJacksonville, NC 28546
Joel Shulkin, M.D., FAAPAPO, AE 09137-0200
Scott Stuart, M.D., FAAPGoosecreek, SC 29445
Vermont
Stephen Reville, M.D., FAAPSpringfield, VT 05156
Susan Scoft, M.D., FAAPEssex Junction, VT 05452-3945
Arvin Garg, M.D., FAAPPlainsboro, NJ 08536-3608
Bruce Grossman, M.D., FAAPMorris Plains, NJ 07950-3333
6aurang Patel, M.D., FAAPAvenel, NJ 07001-1048
Christine Sheehan, D.O., FAAPHaddonfield, NJ 08033-2641
PennsylvaniaAnne Ades, M.D., FAAPPhiladelphia, PA 19118-3417
Brian Alverson, M.D., FAAPPhiladelphia, PA 19103-5957
Song-Ok Chin, M.D., FAAPPlymouth Meeting, PA 19462
Orthopaedics Specialty FellowTheociore Ganley, M.D., FAAPPhiladelphia, PA 19104
John Gorlowski, M.D., FAAPSt. Marys, PA 15857-3483
Samir Henien, M.D., FAAPCnr+^n DA 4QnA')-GrfIf)
Thomas Bruns, M.D., FAAPChattanooga, TN 37421-6307
Bradley Carter, M.D., FAAPMemphis, TN 38122-4643
Jason C eney, M.D., FAAPOak Ri ge, TN 37830
Deborah Fernandes,M.D., FAAPDyersburg, TN 38024-6537
Scoft Guthrie, M.D., FAAPHendersonville, TN 37075
Kelly Kriwanek, M.D., FAAPMemphis, TN 38135-0298
Michele Spring, M.D., FAAPNashville, TN 37232-2581
Natascha Thompson,M.D., FAAPCardova, TN 38018-3500
VirginiaCharlofte Collin, M.D., FAAPNorfolk, VA 23502-5260
Indiana
Laura Gaffney, M.D., FAAPIndianapolis, IN 46208
Jeffrey Gatz, M.D., FAAPValparaiso, IN 46383-3277
Brandy Kashyap, M.D., FAAPIndianapolis, IN 46202-4663
Rhoda Yueh, M.D., FAAPIndianapolis, IN 46254-9630
MichiganJudy Black, M.D., FAAPNiles, MI 49120-4083
Amy Cooke, M.D., FAAPAnn Arbor, MI 48103-91 11
Francis Darr, M.D., FAAPCheboygan, MI 49721-9430
Ohio
Yilin Chang, M.D., FAAPFindfay-, OH 45840-5015
Bradley Dixon, M.D., FAAPCincinnati, OH 45209-1840
Katherine Krueck, M.D., FAAPWesterville, OH 43082
Ophthalmology SpecialtyFellowArysol Niffenegger, M.D., FAAPMassillon, OH 44646
Carrie Reed, M.D., FAAPTailmadge, OH 44278
Eriks Usis, M.D., FAAPMentor, OH 44060
Robert Wallace, M.D., FAAPLoveland, OH 45140
: Ontario
: Christine Ricks, M.D., FAAP: Toronto, ON M4V 2L7: Canada
Surgery Specialty FellowOluyinka Olutoye,M.D., Ph.D., FAAPHouston, TX 77030-2399
Christina Purnell, M.D., FAAPCorpus Christi, TX 78411
Antonio Rodriquez, M.D., FAAPLaredo, TX 78045-6304
Michelle Saenz, M.D., FAAPAustin, TX 78746
Susan Smart, M.D., FAAPRockwall, TX 75032-5856
Tammi Williams, M.D., FAAPIrving, TX 75061
Francis Kangethe, M.D., FAAPMatteson, IL 60443-2076
Elizabeth Kramer, M.D., FAAPMorton, IL 61550
Ramzan Shahid, M.D., FAAPMokena, IL 60448-8383
Kathleen Webster, M.D., FAAPOak Park, IL 60304-2020
Iowa
Michelle Miller, M.D., FAAPIowa City, IA 52246-8632
Sara Stover, M.D., FAAPIowa City, IA 52246
Kansas
Kelly Kreisler, M.D., FAAPOverland Park, KS 66209-3716
Chris Stone, M.D., FAAPWichita, KS 67220
Missouri
Michelle Beumer, M.D., FAAPUnion, MO 63084
Jennifer Hulsen, M.D., FAAPSt Louis, MO 63122-2027
Nikoleta Kolovos, M.D., FAAPSt Louis, MO 63130-4026
Fiona Levy, M.D., FAAPSt Louis, MO 631 1 0
Alan Skouitchi, M.D., FAAPSt Louis, MO 63017
Christopher Wilson,M.D., FAAPSt. Louis, MO 63126-3702
Alabama
Surgery Specialty FellowMichael Fuenfer, M.D., FAAPMobile, AL 36607
Elizabeth Peters, M.D., FAAPBirmingham, AL 35235
Jeffrey Tamburin, M.D., FAAPDothan, AL 36305-6919
Arkansas
Richard Reinhard, M.D., FAAPJonesboro, AR 72401
Louisiana
Marlene Broussard, M.D., FAAPShreveport, LA 71118-2021
Brandi Jones, M.D., FAAPNew Orleans, LA 70130-1759
MississippiWilliam Barreft, M.D., FAAPOlive Branch, MS 38654
Texas
Lynae Canales, M.D., FAAPCorpus Christi, TX 7841 1Surge7S cialty Fellow
.peDarre ass, M.D., FAAPHouston, TX 77030-2399
Adeinery Gonzalez, M.D., FAAPSan Antonio, TX 78216-7731
Cheryl Landry, M.D., FAAPLubbock, TX 79423-2926
Kirsten Lentsch, M.D., FAAPRichmond, TX 77469-6112
Kimberly Mehendale,M.D., FAAPDallas, TX 75209-5701
Alaska
Alice Antonescu, M.D., FAAPFairbanks, AK 99709
Eric Noble, M.D., FAAPAnchorage, AK 99507
Arizona
Susan Chung, M.D., FAAPPhoenix, AZ 85020
Jose Fierro Cueto, M.D., FAAPPhoenix, AZ 85018-5438
Kimberly Gerhart, M.D., FAAPPrescoft, AZ 86301
John Hartley, D.O., FAAPPhoenix, AZ 85014-2008
Surgery Specialty FellowDavid Notrica, M.D., FAAPPhoenix, AZ 85006
Colorado
Larry Mafthews, M.D., FAAPLiftleton, CO 80123-2944
Nevada
Daniel Colombo, M.D., FAAPLas Vegas, NV 89145-8850
Shane Rostermundt,D.O., FAAPHenderson, NV 89052
New Mexico
Lisa Jimenez, M.D., FAAPAlbuquerque, NM 87120-4811
Meredith Reynolds,M.D., FAAPRoswell, NM 88201
OregonJeannine Johnson, M.D., FAAPPortland, OR 97229-3685
Scoft Shipman,M.D., M.P.H., FAAPWest Linn, OR 97068
Uniformed Services-West
Amy Belisle, M.D., FAAPApo, AP 96326-7000
Cheryl Okado, M.D., FAAPFPO, AP 96362-0199
Utah
Dale Gerstmann, M.D., FAAPProvo, UT 84604
Shannon Staker, M.D., FAAPRoosevelt, UT 84066
WashingtonJennie Austin, M.D., FAAPMoses Lake, WA 98837
tasion, rA'itsu4z--!oDuu
Ann Roberts, M.D., FAAPPhiladelphia, PA 19107-6021
KentuckyMichelle Bennett, M.D., FAAPLexington, KY 40507-1130
Harohalli Shashidhar,M.D., FAAPLexington, KY 40356-0284
Michelle Sumrall, M.D., FAAPElizabethtown, KY 42701
Massachusetts
Karen A. DeMuth, M.D., FAAPWestwood, MA 02090
North Carolina
Jonathan Brownlee,M.D., FAAPShelby, NC 28150-4718
Dean Cauley, M.D., FAAPElizabeth City, NC 27909
Christina Fi&lozzi, M.D., FAAPWinston Salem, NC27127-5772
Frederick Heweft, M.D., FAAPRaleigh, NC 27614
Ashokkumar Jain, M.D., FAAPFayetteville, NC 28311-2968
Eric Jones, M.D., FAAPCary, NC 27511-8926
Sharmila Jones, M.D., FAAPCary, NC 27511
Vivian Makar, M.D., FAAPDurham, NC 27713
Nicole Safina, M.D., FAAPJacksonville, NC 28546-7043
Frini Shah, M.D., FAAPDurham, NC 27713-9455
South Carolina
Zenaida Candela, M.D., FAAPBenneftsville, SC 29512-2667
Tennessee
Jennifer Amrol, M.D., FAAPNashville, TN 37221-3300
Paul Barongan, M.D., FAAPClinton, TN 37716-2423
p01 P2 9 N tooM
Illinois
Jennifer Blount, M.D., FAAPWheaton, IL 60187
Jeffrey Cabotaje, M.D., FAAPChicago, IL 60614-1758
Youn Hong, M.D., FAAPChicago, IL 60618-7818
278 AAP News wwwaapnewsorg June 2003
N EVV F EL LOVWVS
Troy Jacobs,M.D., M.P.H., FAAPSeattle, WA 98122-0874
James O'Callaghan,M.D., FAAPSeattle, WA 98103
California 1
Stephanie Grayson, M.D., FAAPPalo Alto, CA 94301-2548
California 2
Alexandra Clark, M.D., FAAPLoma Linda, CA 92313
Lori Kandel, M.D., FAAPLos Angeles, CA 90036
Passara Liangthanasarn,M.D., FAAPLong Beach, CA 90806-1646
Annica Lin, M.D., FAAPLos Angeles, CA 90049-7900
Lisa Paquette, M.D., FAAPPasadena, CA 91 105-1329
California 3
Annie Kupelian, M.D., FAAPLaJolla, CA 92037
*California 4
Blake Alban, M.D., FAAP*Los Alamitos, CA 90720
Plastic Surgery Specialty Fell*Michael Sundine, M.D., FAA*Orange,CA92868
Mai-Khanh Tran, M.D., FAA*Fountain Valley, CA 92708
:Gilbert Umnas, M.D..Orange,CA92869
.Alabama
*Eva Allen, M.D., FAAP*Birmingham, AL 35208-341!
*Grant Allen, M.D.,FAAP.Florence, AL 35630
*Florida
*Briggs Carroll, M.D., FAAP*Sarasota, FL 34232-6620
*Shelley Collins, M.D., FAAP*Miami, FL 33129-2306
Margoth Diaz, M.D., FAAP*Miami, FL 33179-2425
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5
:Rogerio Faillace, M.D., FAAP*Lighthouse Point, FL 33064
Philip Floyd, M.D., FAAP*Coral Gables, FL 33146-1806
*Ophthalmology SpecialtyFellow:Robert Gold, M.D., FAAPLongwood, FL 32750
:Sandra Morris, M.D., FAAP*Plantation, FL 33317
Carlos Mujica, M.D., FAAP*Zephyr Hills, FL 33542
Giovanni Piedimonte,M.D., FAAP*Miami, FL33136
Ronald Rempfer, M.D., FAAP*St Petersburg, FL 33702
:Jeth Salomon, M.D., FAAP.St Petersburg, FL 33710-1647
Marilyn Sprenkle, M.D., FAAPDentin, FL 32541
Tonya Williams, M.D., FAAP*Oviedo, FL 32765-5646
.Georgia
*Terrence Gfroerer, M.D., FAAPDunwoody, GA 30338-3751
:Allison Houck, M.D., FAAP*Cordele, GA 31015-0936
Darryl Morris, M.D., FAAP:Atlanta, GA 30342-1605
Carla Neal-Haley, M.D., FAAP*Mabuton, GA 30126
Javier Tejedor-Sojo, M.D., FAAP.Rome, GA 30165
:Puerto Rico
Norma Arciniegas Medina,:M.D., FAAP*Caborojo, PR 00623
*DISTRICT I
*Eileen M. Ouellette, M.D., J.D.Pediatric Neurology
:North Shore Children's Hospital57 Highland Ave.
*Salem, MA 01970-2197.e-mail: eouelletteOaap.org
DISTRICT II
*Robert M. Corwin, M.D.:Medical Director- MedBest251 Salina Meadows Pkwy.
*Suite 100:Syracuse, NY 13212-4572*e-mail: rcorwinOaap.org
: DISTRICT III
.Alan E. Kohrt, M.D.Medical Director/
:Children's Health NetChildren's Hospital ofPhiladelphia
*34th and Civic Center Blvd.:Philadelphia, PA 19104-4399*e-mail: akohrtOaap.org
DISTRICT IV
:David T. Tayloe, Jr., M.D.2706 Medical Office Place*Goldsboro, NC 27534-9460:e-mail: sewardsWaap.org
*DISTRICT V
:Ellen Buerk, M.D.Oxford Pediatrics5141 Morning Sun Rd.*Oxford, OH 45056-9722*e-mail: ebuerkWaap.org
.DISTRICT VI
:Kathryn Piziali Nichol, M.D.:1314 Morrison St.Madison, WI 53703-3812e-mail: knicholQ?aap.org
:DISTRICT Vll
*Gary Q. Peck, M.D.:Office of Public Health:325 Loyola Avenue - Suite 513New Orleans, LA 701 12-1829
*e-mail: gpeckOaap.org
:DISTRICT Vlill
*Jon R. Almquist, M.D.Virginia Mason Medical Center:Departmentof Pediatrics33501 First Way SouthFederal Way, WA 98003-6208
*e-mail: jalmquist?aap.org
:DISTRICT IX
Burton F. Willis, M.D.:9900 TalbertSuite 201*Fountain Valley, CA92708-51 53
*e-mail: bwillisEaap.org
*DISTRICT X
:Charles Linder, M.D.:Medical College of Georgia1120 15th St..Rm. HF1117:Augusta,GA30912-0004*e-mail: clinderOaap.org
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The Department of Pediatrics at Gundersen Lutheran Medical Center in La Crosse, Wisconsin, isseeking a BC/BE Neonatologist to work in our 12 patient NICU/4 patient PICU. There are currentlyfour physicians (one neonatologist, one PNICU physician, one PICU physician, and one generalpediatrician) who cover the PNICU service. N'eonatal nurse practitioners help cover call and dohelicopter and ground transports.The Department of Pediatrics has 20 pediatricians, six PNPs, four NNPs, and one PA. Our pediatricsubspecialty areas include hematology/oncology, orthopaedics, asthma/allergy/immunology, oph-thalmology, surgery, neonatology, neurodevelopment, neurology, genetics, gastroenterology, andpediatric ICU. This position can be part time or full-time (preferably with another pediatric specialtysuch as pulmonology or general pediatrics). Gundersen Lutheran Medical Center is the westerncampus of the University of Wisconsin Medical School.Gundersen Lutheran is a large integrated health system where over 400 medical, dental andassociate staff practice together. La Crosse is a city with a metropolitan population of 1 OOJOOO. Safeneighborhoods, excellent schools, affordable housing, exceptional four season recreationalactivities, and diverse cultural activities converge for a great l'ifestyle in this family-friendly region.
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PEDIATRIC GASTROENTEROLOGISTIf you're looking for a healthcare setfing where you can feel personally and. professionally at home, thenGundersen Lutheran is rigt where you belong. Here, you'll find metropolitan-scale medicine, educationand research amid a small town character and comfort. Gundersen Lutheran Medical Center, a 235-bedteaching hospital with a Level II trauma and emergency center, and its 45 medical facilifies serve morethan 500,000 residents in three states. 'Within our multi-specialty group practice, you'll work with morethan 440 medical staff members within a 25-clinic network practicng in the La Crosse, Wlsconsin area.
The Department of Pediatrics at Gundersen Lutheran is seeling a full-fime pediatric gastroenterologist.The GI departfnent has six board-certified adult gastroenterologi.ss and a state-of-the-art GI procedurelab avaiable.The Departinent of Pediatrics has 20 pediatricians, Six PNPs, four NNPs, and one PA. Our pediatricsubspecWaty areas include hematology/oncology, orthopedics, asthmatallergy/hinmunology,ophthalmology, surgery, neonatology, neurodevelopment, neurology, genetics, and pediatric ICU. Thepediatric inpatient service also includes an eight pafient NICU, a four palient PICU, and a 20 pafientpediatrc inpatient service.
We offer an excellent compensation/benefits package, including relocagon expenses and condnuingeducation opportunifies. Interested candidates should contact Gale Krelbich, Medical StafDevelopment, Gundere Luthera, 1910 Sout Ave., La Crosse, WI 54601 at (800) 362-9567, ExL 56863, Emf: gkreibicEgundluth.org or Dr. Richard Strauss, Chlair, Dept. ofPar aics, Gundersen Lutheran, 1836 South Ave., La Crose, WI 54601 at (800) 362-9567,Ex 52809, lEmafl: rAstraussftundluth.org.
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Dr. Richard Strauss, ChairDepartment of PediatricsGunderson Lutheran1910 South AvenueLa Crosse, WI 54601800-362-9567 Ext. 52809rstraussEgundluth.org
Gale KreibichMedical Staff Development
OR Gundersen Lutheran1910 South AvenueLa Crosse, WI 54601800-362-9567 Ext. 56863gkreibicZ?gundluth.org
280 AAPNews www.aapnews.org June2003
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ZITHROMA)((azithrmnycin for oral suspension)
BRIEF SUMMARYINDICATIONS AND USAGE
ZITHROMAXO (azithromycin) is indicated for the treatment of patients with mild to moderate infections{pneumonia: see WARNINGS) caused bysusceptibe strains of the designated microorganisms in the specificconditions listed below. As recommende dosaaes. durations of theraov. and anolicable Datient pgpulations varyamong these infections. please see DOSAGE AND ADMINISTAINfr specific dosing recomrmendations.~
Acute otitis media caused by Haemophilus imfluenzae, Moraxella catarrhalis, or Streptococcuspneumoniae.(For specific dosage recommendation, see DOSAGE AND ADMINISTRATION.)
Community-acquired pneumonia due to Chlamydia pneumoniae, Haemophi'lus influenzae,Mycoplasma pneumoniae or Streptococcus pneumoniae in patients appropriate for oral therapy. (For specificdosage recommendation, see DOSAGE AND ADMINISTRATION.)
NOTE: Azithromycin should not be used in pediatric patients with pneumonia who are judged tobe inapprpopite for oral therapy because of moderate to severe illness or risk factorssluch as any of the following: patients with cystic fibrosis, patients with nosocomiallyhacquired infections, patients with known or suspected bacteremia, patients requiringhospitalization, or paidents with significant underlying health problemts that maycompromise their ability to respond to their illness (including immunodeficiency orfunctional asplenia).
Pharyngitis/tonsillitis caused by Streptococcuspyogenesas an altemative to first-line therapy inindividuals wvho cannot use first-line therapy. (For specific dosage recommendation, see DOSAGE ANDADMINISTRATION.)
NOTE: Penicillin by the intramuscular route is the usual drug of choice in the treatment of Streptococcuspyogenes infection and the prophylaxis of rheumatic fever. ZITHROMAXO is often effective in the eradication ofsusceptible strains of Streptococcuspyogenesfrom the nasopharynx. Because somne strains are resistant toZITHROMAXI, susceptibilit tests should be performed when patients are treated with ZITHROMAXO. Dataestablishing efficacy of azithromycin in subsequent prevention of rheumatic fever are not available.
Appropriate culture and susceptibility tests should be performed before treatment to determine the causativeorganism and its susceptibilit-y to azithromycin. Therapy with ZITHROMAXI may be initiated before results ofthese tests are known; once tne results become available, antimicrobial therapy should be adjusted accordingly.
CONTRIWNDICATIONSZITHROMAX" is contraindicated in patients with known hypersensitivity to azithromycin, erythromycin or anymacrolide antibiotic.
WARNINGSSerious allergic reactions, including anqioedema, anaphylaxis, and dermatologic reactions including StevensJohnson Syndrome and toxic epidermaT necrolysis have been reported rarely in patients on azithromycin therapy.Although rare, fatalities have been reported. (See CONTRAINDICATIONS.} Despite initially successfulsymptomatic treatment of the allergic symptoms, when symptomatic therapy was discontinued, the allergicsymptoms recurred soon thereafter in some patients without further azithromycin exposure. Thesepatients required prolonged periods of observation and symptomatic treatment. The relationship of theseep'sodes to the long tissue half-life of azithromycin and subsequent prolonged exposure to antigen is unknown atpresent.
If an allergic reaction occurs, the drug should be discontinued and appropriate therapy should be instituted.Physicians should be aware that reappearance of the allergic symptoms may occur when symptomatic therapy isdiscontinued.
In the tramnt of pneumonia, azithrormycin has only been shown to be safe and effective in thetreatment cof community-acquired pneunmoia due to Chlanrydia pnuwoie Haemophilusinfluenzae, AMycoplarna pneunxoniae, or Srpocusnenni in patients appropriate for oraltherapy. Azithrmywcin should not be used i ateswthpumna who are judged to beinaprpmpnate for oral therapy because of moeaet eeeilesor risk factors such as any ofthe following: patients with cystic fibrosis, pabents with nosocomially acquired infections, patientswith known or suspecited bacteremia, patients requiring hospitalizabon, elderly or debilitatedpatients, or patients wit snificant tinderlying health problemis that may compromise their ability torespond to their illness zinudg immunodeficiency or function al asplenia).
Pseudomembranous cltshsbeen reported with nearly all antibacterial agents and may rangein evriyfommid t lfethratniq.Theretore, it isimportant toconsider this diagnosis inpatintswhopresnt ithdiaffhea subsequent to the administration of antibacterial agents.
Treamenwih atibcteialagents alters the normal flora of the colon and may permit overgrowth ofclostridia. Studies indicate that a toxin produced by Clostridium difficile is a primary cause of "antibiotic-associated colitis."
After the diagnosis of pseudomembranous colitis has been established, therapeutic measures should beinitiated. Mild cases of pseudomembranous colitis usually respond to discontinuation of the drug alone.In moderate to severe cases, consideration should be given to management with fluids and electrolytes, proteinsupplementation, and treatment with an antibacterial drug clinically effective against Clostridium difficile colitis.
PRECAIJTIONSGeneral: Because azithromycin is principa~lly eliminated via the liver, caution should be exercised whenazithromycin is administered to patients with impaired hepatic function.
There are no data regardingq azithromycin usage in patients with renal impairment, thus, caution should beexerc'sed when prescribing azithromycin in these patients.
The following adverse events have been reported with macrolide products: ventricular arrhythmias, includingventricular tachycardia and torsades de pointes, in individuals with prolonged OT intefvals.
There has been a spontaneous report trom the post-marketing experience of a patient with previous history ofarrhythmias who experienced torsades de ,oointes and subsequent myocardial infarction following a course otazithromyi therapy.IIIFIIIabUU for Patients: Zithromax* oral suspension can be taken with or without food.
Patients should also be cautioned not to take aluminum- and magnesium-containing antacids andazithromycin simultaneously.
The patient should be directed to discontinue azithromycin immediately and contact a physician if any signs ofan allergic reaction occur.Drug Interactions: Aluminum- and magnesium-containirig antacids reduce the peak serum corcentrations (rate) butnot the AUC (extent) of azithromycin absorption.
Administration of cimetidine (800 mg) two hours prior to azithromycin had no effect on azithromycinabsorption.
Azithromycin did not affect the plasma concentrations or pharmacokinetics of theophylline administered as asingle intravenous dose. The effect of azithromycin on the plasma concentrations or pnarmacokinetics oftheophylline administered in multiple doses resuiting in therapeutic steady-state concentrations of theophylline isnot known. However, concurrent use of macrolides and theophylline has been associated with increases in theserum concentrations of theophylline. Therefore, until further data are available, prudent medical practicedictates careful monitoring of plasma theophylline concentrations in patients receiving azithromycin andtheophylline concomitantly
Azithromycin did not affect the prothrombin time response to a single dose of warfarin. However, prudentmedical practice dictates careful monitoring of prothrombin time in alltpatients treated with azithromycin andwarfarin concomitantly. Concurrent use of macrolides and warfarin in clinical practice has been associated withincreased anticoagulant effects.
The following druwQ interactions have not been reported in clinical trials with azithromycin; however, nospecific drug interaction studies have been performed to evaluate potential drug-drug interaction. Nonetheless,they have been observed with macrolide products. Until further data are developed regarding drug interactionswhen azithromycin and these drugs are used concomitantly, careful monitoring of patients is advised:
Digoxin-elevated digoxin concentrations.Ergotamine or dihydroergotamine-acute ergot toxicity characterized by severe peripheral vasospasm anddysesthesia.Triazolam-decrease the clearance of triazolam and thus may increase the pharmacologic effect of triazolam.Drugs metabolized by the cytochrome P450 systemi-elevations of serum carbarnazepirie, terfenadine,cyclosporine, hexobarbital, and phentoin concentrations.LabortoryTeslInteactins Tere are no reported laboratory test interactions.Carcioqensis,Mutaeness, Impairment of Fertility: Long-term studies in animals have not beenperfrmetoevalatecarinoenic potential. Azithromycin has snown no mutagenic potential in standardlabratrytess: oue Impoma assay, human lymphocyte clastogenic assay, and mouse bone marrowclasogeicssayNo vidnceof impaired fertility due to azithromycin was found.
Prenany:eraogeic ffets.Prenancy Category B: Reproduction studies have been performed in rats andmice~~ ~ ~~~atdssu omdeaeymtraly toxic dose concentrations (i.e., 200 mg/kg/day). These doses, based
on a mg/ml basis, are estimated to be 4 and 2 times, respectively, the human daily dose of 500 mg. In the animalstudies, no eviderice of harm to the fetus due to azithromycin was found. There are, however, no adequate andwell-controlled studies in pregnant women. Because animal reproduction studies are not always predictive ofhuman response, azithromycin should be used during pregnancy only if clearly needed.Nursing Mothers:lt'isnot knowfnwhether azithromycin is excreted in human milk. Because many drugs areexcreted in human milk caution should be exercised when azithromycin is administered to anursing woman.Pediatric Use: (See INDICATIONS AND USAGE AND DOSAGE AND ADMINISTRATION.)
Acute Otitis Media (total dosage regimen: 30mg/kg, see DOSAGE AND ADMINISTRATION): Safety andeffectiveness in the treatment of children with otitis n;edia under 6 months of age have not been established.
Community-Acquired Pneumonia (dosage regimen: 10 mg/kg on Day 1 followed by 5 mg/kg on Days 2-5):Safety and effectiveness in the treatment of children with community-acquired pneumonia under 6 months ofage have not been established. Safety and effectiveness for pneumonia due toChlamydia pneumoniae andMycoplasma pneumoniae were documented in pediatric clinical trials. Safety and effectiveness for pneumoniadue to Haemophilus influenzae and Streptococcus pneumoniae were not documented bacteriologically in thepediatric clinical trial due to difficulty in obtaining specimens. Use of azithromycin for these twomiCrOOrganiSmS iS supported, however, by evidence from adequate andwell-controlled studies in adults.
Pharyngitis/Tonsillitis (dosage regimen: 12 mg/kg on Days 1-5): Safety and effectiveness in the treatment ofchildren with pharyntqitis/tonsiTlitis under 2 years ot age have not been established.
Studies evaluating the use of repeated courses of therap have not been conducted.Geriatric Use: Pharmacokinetic parameters in older voIlinteers (6585 years old) wvere similar to those inyounger volunteers (18B-40 years old) for the 5--day therapeutic regimen. uosage adjustment does not appear tobe necessary for older patients with normal renal and hepatic function receivng treatment with this dosage
regimen. ~~~ADVERSE REACTIONSIn clinical trials, most of the reported side effects were mild to moderate in severity and were reversible upondiscontinuation of the drug. Potentially serious side effects of angioederma and cholestatic jaundice werereported rarely. Approximately 0.7% of the patients (adults and children) from the 5-day multiple-dose clinicaltrials discontinued ZITHROMAXO (azithromycin) therapy because of treatment-related side effects. In clinicaltrials in children given 30 mg/kg, either as a single dose or over 3 days, discontinuation from the trials due totreatment-related side effects was approximately 1%. (See DOSAGE AND ADMINISTRATION.) Most of theside effects leading to discontinuation were related to the gastrointestinal tract, e.g., nausea, vomiting, diarrhea,or abdominal pain.Clinical:Children: Single and Multiple-dose regimens The types of side effects in children were comparable to thoseseen in adults, with different incidence rates for the dosage regimens recommended in children.Acute Otitis Media: For the recommended total dosage regimen of 30 mg/kg, the most frequent side effects(2 %) attributed to treatment were diarrhea, abdominal pain, vomiting, nausea and rash. (See DOSAGE ANDADMINISTRATION.) The incidence, based on dosing regimen, is described in the table below:
Dosage Diarrhea, % Abdominal Vomiting,% Nausea, % Rash, %Regimen Pain, %/-n1 -day 4.3% 1.4% 4.9% 1.0% 1.0%3-day 2.6% 1.7% 2.3% 0.4% 0.6%5-day 1.8% 1.2% 1.1% 0.5% 0.4%
Community-Acquired Pneumonia: For the recommended dosage regimen of 10 mg/kg on Day 1 followed by 5mg/kg on uays 2-5, the most frequent side effects attributed to treatment were diarrhea/loose stools (5.8%),abdominal pain, vomiting, and nausea (1.9% each), and rash (1.6%).
Pharyngitis/tonsillitis: For the recommended dosage regimen of 12 mq/kg on Days 1-5, the most frequentside effects attributed to treatment were diarrhea (5.4%), vomiting (5.6%), abdominal pain (3.4%), nausea (2%),rash (0.7%), and headache (1.1%).
With an of the treatment regimens, no other treatment-related side effects occurred in children treated withZITHROMAX- with a frequency greater than 1%. Side effects that occurred with a frequency of 1% or lessincluded the following:Cardiovascular. Chest pain.Gastrointestinal: Dyspepsia, constipation, anorexia, enteritis, flatulence, gastritis, jaundice, loose stools andoral moniliasis.Heaooic aind Lymphatic: Anemia and leukopenia.NouSytm: Headache (otitis media dosage), hyperkinesia, dizziness, agitation, nervousness and insomnia.GnrlFee,face edema, fatigue, fungal infection, malaise and pain.
Allergic: Rash and allergic reaction.Respiratory: Cough increased, pharyngitis, pleural effusion and rhinitis.Skin and Appendages: Eczema, fungal dermatitis, pruritus, sweating, urticaria and vesiculobullous rash.Special Senses: ConJunctivitis.Post-Marketing9 Experience: Adverse events reported with azithromycin during the post-marketing period inadult and/or pediatric patients for which a causal relationship may not be established include:-Allerg9ic: Arthralgia, edema, urticaria and anMqioedema.Cardiovascular Arrhythmias including ventricular tachycardia and hypotension.Gastrointestinal: Anorexia, constipation, dyspepsia, flatulence, vomiting/diarrhea rarely resulting. indehydration, pseudomembranous colitis, pancreatitis, oral candidiasis and rare reports ot tongue discoloration.General: Asthenia, paresthesia, fatigue, malaise and anaphylaxis (rarely fatal).Genitourinary: Interstitial nephritis and acute renal failure and vaginitis.Hematopoietic: Thrombocytopenia.Uver/Biliary: Abnormal liver function including hepatitis and cholestatic jaundice, as well as rare cases ofhepatic necrosis and hepatic failure, some of which have resulted in death.Nervous SysteFm Convulsions, dizziness/vertigo, headache, somnolence, hyperactivity, nervousness, agitationand syncope.Psychiatric: Aggressive reaction and anxietySkinAppndags: rurius,rarely serious slkin reactions including erythema multiforme, Stevens-Johnsonsyndomend txic pidemalnecrolysis.SpecalSnses Heaing istrbances including hearing loss, deafness and/or tinnitus and rare reports of taste
Perversion.Laboratory Abnormalities:Children:One, Three and Five Day RegimensLaboratory data collected trom comparative clinical trials employing two 3-day regimens (30 mg/kg or 60 mg/kgin divided doses over 3 days), or two 5-day regimens (30 mg/kg or 60 mg/kg in divided doses over 5 days) weresimilar for regimens of azithromycin and ail comparators combined, with most clinically significant laboratoryabnormalities occurring at incidences of 1-5%. Laboratory data for patients receiving 30 mg/kg as a single dosewere collected in one single center trial. In that trial, an absolute neutrophil count between 500-1500 cells/mm'was observed in 10/64 patients receiving 30 mg/kg as a single dose, 9/62 patients receivinq 30 mg/kg givenover 3 days, and 8/63 comparator patients. No patient had an absolute neutrophil count <5 0 cells/mm3. (SeeDOSAGE AND ADMINISTRATION)In multiple-dose clinical trials involving approximately 4700 pediatric patients, no patients discontinued therapybecause of treatrrent-related laboratory abnormalities.
DOSAGE AND ADMINISTRATION (See INDICATIONS AND USAGE)Zithromaxl for oral suspension can be taken with or without food.Acute Otitis Media: The recommended dose of ZITHROMAX$ for oral suspension for the treatment of childrenwith acute otitis media is 30 mg/kg given as a single dose or 10 mg/kq once daily for 3 days or 10 mq/kg as asingle dose on the first day followed by 5 mg/kg/day on Days 2 through 5. The safety of re-dosing azithromycin inchiidren who vomit after receiving 30 mg/kg as a single dose has not been established. In clinical studiesinvolving 487 patients with acute otitis meaia given a single 30 mg/kg dose of azithromycin, eight patients whovomitea within 30 minutes of dosing were re-dosed at the same total dose.Convnunity-Acquired Pneumonia: The recommended dose of ZITHROMAX(@ for oral suspension for thetreatment of children with community-acquired pneumonia is 10 mg/kg as a single dose on the first day followedbv5 mgAgu on Days 2 though 5.%Paryngitis/Tonsillits: The recommended dose of ZITHROMAXO for children with pharyngitis/tonsillitis is
12 mg/kg once daily for 5 days.Formore detailedproduct information please refer to the fullprescribing information orcall 1M8079-3477.
Rev.9 January 2002
- ~~~~M1New York - I am a Pediatrician looking for a full orpart time clinic/practice setting in the New YorkCity area. Please call Susan at (212) 717-9505.
SOUTHEAST
ENERGETIC BC/BE PEDIATRICIAN WANTED tojoin dynamic, academically-oriented nationallyrespected practice in Dade, Broward and PalmBeach County, Florida. Immediate openings in ourPalm Beach locations. Unparalleled lifestyle forprimary care pediatrician with exceptional salaryand benefits. Reply to: Pediatric Associates, PA4620 North State Rd., 7 Ste., 316, LauderdaleLakes, FL 33319, Attention: Peter Shulman, M.D.,Physician Recruiting, or fax a current CV to (954)967-641 0.
Kentucky: BC/BE Pediatrician needed in HPSA loca-tion. J-1, Hl B permanent resident or U.S. citizen allwelcome. Computer literacy preferred. Send CV to:AAP 6, P.O. Box 969, Abingdon, MD 21009.
FLORIDA, Okeechobee. June 2003 opening.Community health center seeks experienced BCPediatrician. Bilingual (Spanish/English) preferred.Limited hospital. Competitive salary and great ben-efits including FTCA liability coverage. Fax resumeto: Medical Director, (561) 844-1013 or e-mailhrOfchcinc.org. EOE/DFWP
PRIMARY CARE PEDIATRICIAN - Atlanta, Georgia- Children's Healthcare of Atlanta is one of thelargest children's health care facilities in the coun-try. We have 430 licensed beds in 2 hospitals plus16 satellite locations throughout metro Atlanta,including 5 immediate care centers, 4 primary carecenters, and other facilities providing outpatientrehabilitation and other specialty care. We have acurrent opportunity available for a full-time PrimaryCare Physician who is fluent in Spanish. This indi-vidual will serve a primarily Hispanic populationand work out of our Chamblee, Georgia primarycare office in metro Atlanta, which is convenient toBuford Hwy. and inside 1-285. Please inquire aboutChildren's generous benefits. For considerationplease submit your CV to: Children's Healthcare ofAtlanta, Attention: Diane Pelzek, ManagerPhysician Recruitment, 1711 Tullie Circle NE,Atlanta, GA 30329; Fax: (770) 592-0917; Phone:(800) 773-4742. You may e-mail: diane.pelzekQachoa.org. For more information about Children's,please visit: www.choa.org. EOE - Children'sHealthcare of Atlanta.
NORTHWEST
NeonatologistThe Great Falls Clinic is looking for a BC/BENeonatologist interested in joining the Neonatologydepartment of a 100+ provider, multi-specialtyorganization. This position will provide the rightcandidate with the unique opportunity to work in aprogressive level 3 nursery engaged in multi-disci-plinary care; tackle challenging neonatal cases; workwith conventional/high frequency ventilation andnitric oxide therapy; and collaborate with a nation-ally recognized perinatologist, and broad base ofsubspecialty providers and surgeons. The Great FallsClinic does not qualify for J-1 waiver status. GreatFalls is a family-friendly community with excellentschools, low crime, clean air, and a reasonable costof living. In addition, you will have access to world-class recreational venues, outdoor activities, scenicvistas and regional culture right outside your prac-tice door. Qualified candidates will have excellentclinical and interpersonal skills, be a team playerand enjoy working closely with families and otherphysicians. The Great Falls Clinic offers a competi-tive benefit package and salary leading to partner-ship. For more information please submit CV andprofessional goals to Ray Geyer, D.O., MedicalDirector, Great Falls Clinic, LLP, 1400 29th St. South,Great Falls, MT 59405 or e-mail: ray.geyerEgfclinic.com.
-L -
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Pediatric NeurologistThe Great Falls Clinic is looking for a full-time pedi-atric neurologist to join a Pediatric department thatconsists of a pediatric cardiologist, pediatric pul-monologist, 2 developmental pediatricians, pedi-atric ophthalmologist and 8 general pediatricians.This position will be office-based with hospital con-sultations, on-call duties limited to neurology con-sults only, and a desire to develop outreach clinics.Our local hospital has tertiary level NICU and abusy high-risk perinatology service. Great Falls isa warm and safe community perfect for a physicianinterested in making a home for themselves and/ortheir family. Access to world-class recreational ven-
ues, outdoor activities, scenic vistas and regionalculture right outside your practice door. Does notqualify for J-1 waiver status. Contact: Ray Geyer,D.O., Medical Director, Great Falls Clinic, P.O. Box5012, Great Falls, MT 59403-5012 or fax CV to:(406) 771-3021; or e-mail ray.geyerOgfclinic.com.Web site: www.gfclinic.com.
HARRI ET LAN E - REPORT TO DEVELOPI NGCOUNTRIES - The Children's Health OrganizationRelief and Educational Services (CHORES) andSepracor Inc. need your help in collecting used
copies of the Harriet Lane Handbook (1 5th EditionONLY) so that we may ship them to pediatricpractitioners in developing countries. Please shipto: CHORES, 1015 Atlantic Blvd. #155, AtlanticBeach, Florida 32233. We thank you. Check outCHORES - www.chores4kids.org.
PEDIATRIC BOARD REVIEW COURSE CoreContent - Comprehensive Review - NO PASS -
NO PAY!! St. Louis Oct. 12 - 16, 2003 43 AAPcredits Tuition: $795.00. www.pediatricboards.com. 1-800-MED-TEST (633-8378) pediatricboardsOaol.com.
Augmentin lamoxicillir/clavulanate potassium) is a registered trademark of GlaxoSmithKline.References: 1. Data on file. Pfizer Inc., New York, NY. L Block SL, Arrieta A, Seibel M, McLinn S, Eppes SC. Single dose azithromycin (30 mg/kg) in acute otitis media. Paper presented at IDSA 38th Annual Meeting;September 7-10, 2000; Newv Orleans, La. Abstract 174.
45DU.S. PharmaeeutiealhAll rights reserved.ZX120881 G) 2002 Pfizer Inc.
June2003 www.aapnews.org AAPNews 2811
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