~iI

P rih~~~~0 0 0~.s

\~~~~~~~~~~t

\~~~~~00gi >*E-Zs~~~~~~ -

'ortable, fits easily intoi pocket .. .

* * ~Durable, No bags or

i ~mouthpieces to changeL ~~....Easy to Use and Clean

*For smaller children,use the soft detachablevalved mask to helpwith inhalation

Our uniqe pull handle serves asa storage point for your medication. . a

Always together, Alway/s Ready* E-Z Spacer is covered bymany insurance companies *

_ *~~E-Z Spacer collapses, allowing the_ ~~~patient to see they are rece'iv'ing_ ~~~their medication

r¢ 40

For inore information Cal 1-800-262-95or Visit our e ucadona website at www.weez.,comn

WVE Pharniaceuticals Inc,

Make The E~~~A-ZSACRYourAsthma Spacer Of Choice. .~~~~~~~~

It Today!

JLA "

1.SpacerAWP $19.201. Spacer and Mask AWP $26.22

00000**009069990009*

a-i*Xa. m .

I. .. ..a

t Ia_)I

~ 1,"IWMIWA~~~~

Narlito Cruz, M.D.1503 E College St., #6Bainbridge, GA 31717

*Cecilia Ong, M.D.*502 E Gen Steward Way #A*.Hinesville, GA 31313

Vernon Whitley, M.D.*403 Timberland Dr.Cordele, GA 31015

.*Kentucky*.Bernadette Smith, M.D.P.O. Box 55246

*.Lexington, KY 40555

*Shelly Voet, M.D.735 Mill Valley Dr.Taylor Mill, KY 41 015

North Carolina

JJDaumen, M.D.3803 A Computer Dr., Ste. 200Raleigh, NC 27609

Angelica Ha, M.D.15 Drummond Ct.Durham, NC 27713

*Kelly Henchel, M.D.1702 Medical Park Dr.Wilson, NC 27895

*.Bindi Nikhar, M.D..1912W BSt.*.Butner, NC 27509

William Stewart, M',D.12460 Angus Dr.I

*.Laurinburg, NC 28352

Susan Vest, M.D.*Lincolnton Medical Group.1470 EastGaston St., Ste. 300P.O. Box 827

*Lincolnton, NC 28092

South Carolina

Sarah Grooms, M.D.13 Crescent Lake Ct.

*.Blythewood, SC 29016

John Tiffany, M.D.Southside Pediatrics*1050 Seven Oaks Dr.Aiken, SC 29803

*.Robert Whitaker, M.D.*.7036 Broad River Rd.*.Irmo, SC 29063

*Tennessee

Gurpreet Bullen, M.D.*5405 Mill Ridge Dr.Knoxville, TN 37919

*.Lisa Chang, M.D.*.4501 Lynnmont Rd., Apt. 27Knoxville, TN 37921

*Scott Howard, M.D.3106 Earnett St.Memphis, TN 38128

*.Maria Javier, M.D.515 Morrell Rd., Apt. Gl110Knoxville, TN 37919

James Montgomery, M.D.*8025 Stage Hills Blvd.*Bartlett, TN 38133

Chetan Mukundan, M.D.*.2400 Patterson St., Ste. 304*Nashville, TN 37203

.Virginia*.Dennis Rustom, M.D.*.5491 Beechtree Dr.*Warrenton, VA 20187

Indiana

Kenneth Liu, M.D.508 LaGrange St.West Lafayette, IN 47906

Karyn Mac Neil, M.D.4006 St. Andrews Cir., Apt. 2BMishawaka, IN 46545

MichiganMegan Clark, M.D.710 Kenmoor SE, Ste. 1 10Grand Rapids, MI 49546

Kiros Mekonnen, M.D.25964 Kilreigh Ct.Farmington Hills, MI 48336

Farhat Osman, M.D.640 Pine Valley WayBloomfield Hills, MI 48302

Sherif Taha, M.D.7740 Reuter St., #F2Dearborn, Ml 48126

Ohio

Theresa Alderson, M.D.2717 Hyde Park Ave.Cincinnati, OH 45209

Katherine Brown, M.D.1025 Winding Creek Ln.Lyndhurst, OH 44124

Jana Doone, M.D.33 Ponds Side Dr.Fremont, OH 43420

Gurjit Hershey, M.D.Children's Hospital Med. Center3333 Burnet Ave., TCHRF-4447Cincinnati, OH 45229

Agnes Laus, M.D.1708 Longwood Dr., NELancaster, OH 43130

Michelle Levitt, M.D.723 Lake St., NWDover, OH 44663

Douglas Moses, M.D.1014 Nantucket Dr.Hermitage, PA 16148

Meri Reinhart, M.D.Anderson Hills Pediatrics Inc7400 Jager Ct.Cincinnati, OH 45230

Wasim Saadeh, M.D.20000 Lorain Rd., #518Fairview Park, OH 44126

*Troy Sands, M.D.*266W Streetsboro Rd.Hudson, OH 44236

Kimberly Vacca, M.D.3104 Cassidy PI.Huron Township, OH 44839

.Ontario

Candice Benjamin, M.D.Hospital for Sick Children555 University Ave.Toronto, ON M5G 1X8

.: Canada

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

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

Connecticut

Akhil Sharma, M.D.51 John Olds Dr., Apt. #210Manchester, CT 06040

Jonathan Stein, M.D.84 Bartlett Dr.Madison, CT 06443

Maine

John O'Brien, M.D.42 Tailwind Ct., #81-DAuburn, ME 04210

Beth Rockcress, M.D.1 1 Mechanic St.Kennebunk, ME 04043

Massachussetts

Elinor Kelliher, M.D.108 Wedgewood Dr.Ludlaw, MA 01056

Gary Nielan, M.D.2207 Boston Rd.Wilbraham, MA 01095

Anesthesiology Specialty FellowSulpicio Soriano, M.D.Children's Hosp-Dept. of Anes300 Longwood Ave.Boston, MA 0211 5

New HampshireUrsula Kneissl, M.D.19 Merrimack StConcord, NH 03301

Quebec

Kent Saylor, M.D.P.O. Box 113Kahnawake, PQ JOL 1 BOCanada

ermont

Amy Ferguson, M.D.29 Ridgewood Rd.Springfield, VT 05156

New York 1

Benjamin Alouf, M.D.71 Willow St.Guilderland, NY 12084

Shephali Katira, M.D.57 Wagon Wheel Dr.East Amherst, NY 14051

Donna Meyer, M.D.Mendon Pediatrics30 Assembly Dr., Ste. 105Mendon, NY 14506

NewYork2

Joseph Accetta, D.O.100 Westwood Dr., #193Westbury, NY 11590

Lynn Cetin, M.D.42 Yukon Dr.Woodbury, NY 11797

Marie-Paule Dupiton, M.D.107-14 225th St.Queens Village, NY 11429

Orthopaedics Specialty FellowSusan Haralabatos, M.D.Dept. of OrthopaedicsSUNY at Stony BrookHSC T-18, Rm. 020Stony Brook, NY 11794

Hillary Kruger, M.D.Maimonides Medical Center4802 Tenth Ave.Brooklyn, NY 11219

Kamal Singh, M.D.15 Crest Hollow Ln.Manorville, NY 11949

New York 3

Fernando Ginebra, M.D.129-5 S Highland Ave., Apt. B2Ossining, NY 10562

Marc Habert, M.D.New Rochelle Pediatric Group140 Lockwood Ave.New Rochelle, NY 10801

Masayo Ogawa, M.D.56 Mountainview Ave.Nyack, NY 10960

Cornelia-Luiza Ratanu, M.D.392 Central Park West., #3HManhattan, NY 10025

Lisa Saiman, M.D.Columbia UniversityDept. of Peds BB4-427650W 1 68th St.New York, NY 10032

Todd Schiffer, M.D.*49 High Ridge Rd.*Mount Kisco, NY 10549

Sudha Varma, M.D.515 W 59th St., #27R*New York, NY 10019

Michael Lucas, M.D.99 Hana Rd.Edison, NJ 08817

Inna Meskin, M.D.855 Valleybrook Ave., #1 BLyndhurst, NJ 07071

Benjamin Piantedosi, M.D.42 Roseberry Ct.Deptford, NJ 08096

Jose Mari Yuvienco, M.D.970 Indian Hill Rd.Toms River, NJ 08753

West VirginiaJohn Seegar, M.D.P.O. Box 839Franklin, WV 26807

Pennsylvania

Joseph Aracri, DO1301 DormontAve.Pittsburgh, PA 15216

Sidney Don, M.D.167 Yew Rd.Cheltenham, PA 19012

Aleksandra Gabryel-Grudziak, M.D.608 Orchard Hill Dr.Pittsgburgh, PA 15238

Kenneth Gelman, M.D.10 Creekview Terr.Lafayette Hill, PA 19444

Eli Lourie, M.D.600 Haverford Rd., Ste. 100Haverford, PA 19041

Parisa Mohammad-Razi, M.D.138 Montrose Ave., #11Rosemont, PA 19010

Michael Nicholas, M.D.708 Shady Retreat Rd., Ste. 3 & 4Doylestown, PA 18901

Keith Pirl, M.D.New Kensington Health Ctr.1260 Martin Ave.New Kensington, PA 15068

Rowena Engracia Rivera, M.D.705 N Elmer Ave., Apt. #8Sayre, PA 18840

Dan Via, M.D.101 Clara CrokerWilliamsburg, VA 23185

_a_[~~~go.EIllinois

Carl Baum, M.D.Children's Memorial HospitalDiv. of Emergency Medicine2300 Children's Plaza., #62Chicago, IL 60614

Brian Hirsch, M.D.1775 Walters Ave.Northbrook, IL 60062

Corinne Lehmann, M.D.818 Fair Oaks Ave.Oak Park, IL 60302

Orthopaedics Specialty FellowPeter Smith, M.D.Shriners Hospitals for Children2211 N Oak Park Ave.Chicago, IL 60707

Natalya Vernovsky, M.D.Suburban Pediatrics Ltd.9101 N Greenwood Ave.Niles, IL 60714

John Lee Webb, M.D.5900 Dover Dr.Lisle, IL 60532

Iowa

Marie Elizabeth Svatek, M.D.8812 Deer Pk.Cedar Rapids, IA 52411

Minnesota

James Nixon, M.D.5553 45th Ave SMinneapolis, MN 55417

Naomi Palmer, M.D.7612 Vinewood Ct.Maple Grove, MN 55311

Angela Thompson-Busch, M.D.11595 Carriage Ct.Eden Prairie, MN 55344

Missouri

Sean Mc Enaney, M.D.1100WTenth St., #175Rolla, MO 65401

Wisconsin

Matthew Biebel, M.D.Waukesha Pediatric Associates Ltd.1 111 Delafield St., Ste. 115Waukesha, WI 53188

Mary Beth Sinclair, M.D.10903 N Beechwood Dr.Mequon, WI 53092

Mark Staszkiewicz, M.D.925 Squire Ln.West Bend, WI 53090

Delaware

Pankaj Sanwal, M.D.1212 Savannah Rd.Lewes, DE 19958

MarylandDiane Ferran, M.D.10696 Weymouth St., #202Bethesda, M.D. 20814

Patricia Jonas, M.D.NNMC - Dept. of Pediatrics8901 Wisconsin Ave.Bethesda, M.D. 20889

Maria Luisa Santos, M.D.9617 Lambeth Ct.Columbia, M.D. 21046

New JerseyZenaida Aranda, M.D.249 Clendenny Ave.Jersey City, NJ 07304

Guo-Pao Cheng, M.D.160 Bloomfield Ave.Bloomfield, NJ 07003

Michael Falk, M.D.Atrium Pediatrics500 Lippincott Dr.Marlton, NJ 08053

Bradley Gribin, M.D.Monmouth Pediatric Group272 Broad St.Red Bank, NJ 07701

Ilene Laufer, M.D.18 Kershner PI.Fairlawn, NJ 07410

Florida

Maura Cintas, M.D.10090 SW 26th Terr.Miami, FL 33165

Emergency MedicineSpecialty FellowMark Clark, M.D.700 Hardman Dr.Orlando, FL 32806

Deborah Kramer, M.D.1611 NW 1 2th Ave.ACC West Bldg. 5AMiami, FL 33136

Luz Pages, M.D.15550 NW 82nd PI.Miami, FL 33016

Georgia

Cynthia Amitin, M.D.141 BriarvistaWayAtlanta, GA 30329

Roland Boyd, D.O.4715 Waltons Cir.Evans, GA 30809

__IAl

Arkansas

Orthopaedics Specialty FellowLaurie Hughes, M.D.Arkansas Children's Hospital800 Marshall St., Slot 839Little Rock, AR 72202

Louisiana

Anne Boudreaux, M.D.807 Ridgefield Rd.Thibodaux, LA 70301

Jean Tran, M.D.North Oaks Pediatric Clinic15756 Medical Arts Plz.Hammond, LA 70403

32 AAP News July 1999

iam ¢rrS \ t w , t t > b ^ 1 t w A w - r tK t \ A S t \ e k \ '*t \ K a 4_" ^_ S ,: _r : **8vs-t beff rJ V" *. _- _,irn -z, 2 V J =- d . 41 ,_ X t XDISTRICT I

Eileen M. Ouellette, M.D., JDPediatric NeurologyNorth Shore Children's Hospital57 Highland Ave.Salem, MA 01970

DISTRICT II

Louis Z. Cooper, M.D.Department of PediatricsColumbia UniversityRoom BHS 114630 W. 168th St.New York,NY 10032

DISTRICT III

Susan S. Aronson, M.D.605 Moreno Rd.Narbeth, PA 19072-161 8

DISTRICT IV

E. Stephen Edwards, M.D.2800 Blue Ridge Blvd.Suite 501Raleigh, NC 27607

DISTRICT V

Stanford A. Singer, M.D.36700 Woodward Ave.Suite 300Bloomfield Hills, MI 48304

Namrata Masih, M.D.Dept. of Pediatrics4800 Alberta Ave.El Paso, TX 79905

Jon Tyson, M.D.UT - Houston Medical SchoolDept. of Pediatrics6431 Fannin, MSB 3.228Houston, TX 77030

Guillermo Urueta, M.D.Eagle Pass Pediatric Health Clinic2198 E Garrison St.Eagle Pass, TX 78852

Daniel Vernier, M.D.2101 Springcress Dr.McKinney, TX 75070

Jay Weinberg, M.D.New Braunfels Pediatric Assoc.1535 East CommonNew Braunfels, TX 78130

Alaska

Ronit Herzog, M.D.1905 Northwestern Ave.Anchorage, AK 99508

Arizona

Lee Addison, M.D.San Carlos Indian HospitalP.O. Box 208San Carlos, AZ 85550

*Julie Becker-Cordova, M.D.7530 E La Cienega Dr.Tucson, AZ 85715

I

MiSSISSippiMaria Desquitado-Tabora, M.D.803B Azalea Dr.Waynesboro, MS 39367

Texas

Arnel Arquisola, M.D.6502 Nursery Dr., Ste. 300Victoria, TX 77904

Leopoldo Cabrera, M.D.St. Mary's Health Care Center5114 97th St.Lubbock, TX 79424

Ronald Chediak, M.D.501 N Barron St.Rusk, TX 78785

Adel ElHennawy, M.D.5440 N Brasewood., Apt. 980Houston, TX 77096

Suma Gollahalli, M.D.1108 Hidden Ridge Dr., #2044Irving, TX 75038

Rose Lynn Lange, M.D.Texas Tech UniversityDept. of Pediatrics4800 Alberta Ave.El Paso, TX 79905

Dynal London, M.D.6900 Scenic Dr., Ste. 103Rowlett, TX 75088

Diane Mc Intire, M.D.5506 74th St.Lubbock, TX 79424

Colorado

Nancy Greer, M.D.6363 W. 1 20th Ave., Ste. 200Bloomfield, CO 80020

Hawaii

Sorbella Guillermo, M.D.91-2139 FortWeaver Rd., #210Ewa Beach, HlI 96706

Utah

Ben Godfrey, M.D.5197 S Spring Gate Dr.Salt Lake City, UT 84117

WashingtonRichard Cuddihy, M.D.4208 W. Lincoln Ave.Yakima, WA 98908

California 1

George Crowl, M.D.1337 N Echo Ave.Fresno, CA 93728

Phyllis Dennery, M.D.Stanford UniversityDept. of Pediatrics750Welch Rd., Ste. 315Palo Alto, CA 94304

Jaling Hua, M.D.7821 Lafayette Ct.Pleasanton, CA 94588

Patrick Quintal, M.D.22032 Grove Cir.Red Bluff, CA 96080

California 2

Gizel Abraham, M.D.1617 Calle Vaquero 302Glendale, CA 91206

Marina Burstein, M.D.5901 W Olympic Blvd., Ste. 503Los Angeles, CA 90036

Andrew Florentino, M.D.3108 Bonner Ct.Lakewood, CA 90712

Philip Lynn, M.D.31017 Hawksmoor Dr.Westminster, CA 90275

E Mackey, M.D.3 Canyon SageIrvine, CA 92620

Frederick Watanabe, M.D.Cedars-Sinai Medical Center8635 W 3rd St., Ste. 590WLos Angeles, CA 90048

California 4

Connie Bartlett, D.O.19341 Weymouth Ln.Huntington Beach, CA 92646

Michelle Bennett, M.D.519 18th St.Huntington Beach, CA 92640

DISTRICT VI

Ordean L. Torstenson, M.D.Dean Medical Center, SC1313 Fish Hatchery Rd.Madison, WI 53715

DISTRICT Vll

L. Leighton Hill, M.D.Office of AdmissionsBaylor College of MedicineOne Baylor PlazaHouston, TX 77030

DISTRICT Vlill

Jon R. Almquist, M.D.Virginia Mason Medical CenterDepartment of Pediatrics33501 First Way SouthFederal Way, WA 98003

DISTRICT IX

Lucy S. Crain, M.D., MPHUCSF Box 0374400 Parnassus Ave.San Francisco, CA 94143

AmericanAcademy ofPediatrics

'Ar

July 1999 AAP News 33

After ten years of agonizing, diapers,and two ineffective drugs, our sonfinally has the confidence for a sleep-over, thanks to the Potty Pager.

Daniel E. Turnbull

It's wireless. It's private. It inspires letters like this.And now it's CLINICA-LLY PROVEN EFFECTIV-E.

In a two year clinical study at the University ofAlabama medical school, thePotty Pager has been proven 71%o effective on hard-to-reach TEEN bedwet-ters. (Lo, Perez, Hanchrow and Joseph)

So whyjust "control" bedwetting with drugs when youcan CURE it! With the WIRELESS alarm that wakesthe BEDWETTER... not the whole house!

The Potty Pager teaches bedwetters to respond normally to bladder fullness.It uses a tactile alarm, much like a silent business pager. It is 100% safe, andcosts just $51.00 + S&H. It comes with a 30 day no-questions guarantee.

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

Or visit our web site: www.pottypager.comIDEAS FORLIVING, INC. BOULDER, COLORADO 80304

because life's challengingenough without a bed-

wetting problem!.

---~ ~ ~ ~~ ~~~~~~~~~~~~~- .= -...m

cs~~~~~~~~~~~~

34 AAP News July 1999

I~~~~~~~~~~~~~~~I__dorI

I

f . t I I<- i !..7i.D

try and enjoy a quality lifestyle inherent to thebeautiful Pacific Northwest! Our physician-managed multispecialty group, which pro-vides care for over 440,000 members ofKaiser Permanente, has a full-time positionavailable for a BC/BE neonatologist at a state-of-the-art level 3 NICU in one of our affiliatedmedical centers in suburban Portland. Dutiesinvolve covering level 3 and 2 newborns in anexpanding 30-bed unit, as well as coordinat-ing newborn services in the greater Portlandarea. Call is shared with a larger neonatalgroup. We offer our physicians a competitivesalary and a benefits package, which includesa generous retirement program, professionalliability coverage, sabbatical leave and more.For information regarding these excitingopportunities, please forward CV to: A.P.Clark, M.D., Regional Medical Director,Northwest Permanente, P.C., 500 NE

MISSISSIPPI

DEPARTMENT OF PEDIATRICS/DIVISIONOF CHILD DEVELOPMENT at University ofMississippi Medical Center in Jackson, has animmediate opening for full-time develop-mental pediatrician (open rank). BC in pedi-atrics and fellowship in developmental pedi-atrics required. Individual will participate inmultidisciplinary team, teaching, research.Please submit CV to Susan Buttross, M.D.,Chief, Division of Child Development, 2500North State St., Jackson, MS 39216-4505.EOE, M/F/D/V.

NORTHERN VIRGINIA -Growing pediatricpractice in Sterling, Virginia, with a reputationfor excellence, looking for BC/BE pediatri-cian to add to our team. Approximately 30minutes west of Washington, DC, just min-

utes from the scenic, rural countryside of theBlue Ridge Mountains. Many cultural andrecreational opportunities; excellent neigh-borhoods and schools. Position is availablenow with a flexible starting date.Competitive salary with good benefiits pack-age. Please contact Shara Messick, (703)444-2675 or 444-3245 or send CV toPediatric HealthCare, PC; 46440 BenedictDr., Ste. 207, Sterling, VA 20164; fax: (703)444-0386; e-mail: misty.mountainEcwi.com

NORTHWEST

NEONATOLOGIST- PORTLAND, OREGON-Northwest Permanente, P.C. has an excel-

lent opportunity for a BC/BE neonatologist tojoin one neonatologist in a stimulating pro-fessional environment with one of the mostsuccessful managed care systems in the coun-

FLORIDA

Busy, established three facility practice SouthBroward, FL looking for BC/BE pediatricianF/T, excellent salary, benefits. Fax CV to:Roberta Martin (954) 967-8962, phone (954)989-6000, ext. 209.

MARYLAND -Immediate opening for full-time BC/BE neonatologist to join group of fiveneonatologists and nine NNP's in clinical prac-tice in 32-bed Level III NICU. 400+ bed hos-pital in suburban D.C. with 6300+ deliveriesannually. Competitive salary, benefits. SendCV and 2 letters of reference to:Neonatology, Holy Cross Hospital, 1500Forest Glen Rd., Silver Spring, MD 20910 orfax (301 ) 754-7484.

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

Chambersburg is located in southcentral PA -whereNEWYORK : you will find the splendor of the mountains, lakes,PENNSYLVANIA )\ farms, and countryside; coupled with theatre'

/I 6 t ] \ ~~music, skiing, fishing, hiking, and much more.

|lWbu *|X hiladelphia} Formore informnation, cal orsendyourC Vto:

\ MARY1AND f<om Marie Royce, Director ofPhysician Relations\ Washington,DC 5 t/SummitHealth\ t1/ Ag ~~~~~P.O.Box 308 * Chambersburg, PA 17201

PVhnn 1-800-758-8835

VlR INI\ FAX: 717-267-7769 www.summiithealth.org

Weatherby Locums is the placement specialist Pe-diatricians count on most!

* Choose from a variety of locafions9 Receive competitive compensationo Paid travel and housingo Paid occurrence-based malpracfice insurance

We accommodate your special circurnstances and pro-vide 24-hour assistance, seven daysperweek. Weatherbywill take care of it all.

For more detailed informnation on available assignments,visit ourwebsite atwuwa.wh#bt. com, call

Frank Phillips, SeniorVice President, 800586 5022, ext 140or e-mail to: fphiffips@whanail.com.

Prefeffed Provider for the American Academy of Pedaaics

*tWeatherby Locums, Inc.Accurate and dqedb k.

5352 NW 21st Teffce * FL Lauderdae, FL 33309

CLASSIFIED ADVERIISING POLICY

Whenyou need to contactpediatricians, contactAAPNews. Each month more than 55,000pediatricians,pediatric specialists, third-year pediatric residents and other subscribers turn toAAPNewsfor child healthinformation they cannotget elsewhere. With a classified ad, you can speak directly to those readers.

Although the Academy believes these classified ads are fromreputable sources, theAcademy does not investigate the offersmade and assumes no responsibility concerning them.

Occassionally, it is necessary to modify the wording of classi-fied ads. These changes are generally made in compliance withthe regulations of various federal and/or state commissionsagainst discrimination or because they might be interpreted asbeing unlawful or in conflict with accepted professional stan-dards of medical practice.

These advertising modifications are made to maintain a clas-sified section that is professionally responsible, lawful, scien-tific and free of discrimination.

Publication of an advertisement in AAP News neither consti-tutes nor implies a guarantee or endorsement byAAP News orthe American Academy of Pediatrics of the product or serviceadvertised or of the claims made for the product or service bythe advertiser.

Classif'ication: Classified ads are accepted under BusinessServices, General Announcements, Medical Meetings, Physi-cians Wanted, Positions Wanted, Practices Available, Publica-tions, Real Estate and Residencies/Fellowships Avaflable.

Display Classified Ads: Camera-ready, 4-color, 3-color and2-color display classified ads are accepted under GeneralAnnouncements, Medical Meetings, Physicians Wanted,Positions Wanted, Practices Available and Residencies/Fellowships Available. Contact Roland Keve, TheWalchliTauberGroup for display classified ad sizes and rates.

For more information, contact: Roland Keve, The WalchliTauber Group, (410) 420-0311, or fax (410) 420-0711. Ad copyis to be sent to: TheWalchliTauber Group, 112W. PennsylvaniaAve., Ste. 201, Bel Air, MD 21014. Payments are to be mailed andmade payable to The American Academy of Pediatrics, Dept.77-5194, Chicago, IL 60678-5194.

The Sisters of the Third Order of St. Francis (OSF) havebeen providing medical care for residents of Illinois, Iowa andMichigan for more than 120 years. Their corporation, nowknown as OSF HealthCare, includes seven hospitals, twoextended care facilities, an insurance company with its ownmanaged care products, more than one dozen affiliatedcompanies providing medical products and services, andOSF Medical Group, a multi-specialty physician group withmore than 220 providers in its multi-state service area. Wenow have general pediatrics opportunities in:

Peoria, Illinois * Escanaba, MichiganFor more information, please contact:

Wendy Bass at (800) 462-3621; Fax (309) 685-2574;Email: wendy.bass@osfhealthcare.org

AAP NEWSPublished MonthyAmerican Academy of PediaricsPO. Box 927ELlk Grove V'llage, IL 60009-0927

MEDICAL GROUP

"jWedotheRight Thing...

Well."

.'~~~~k I

:~ ~ CAG IT 000i

onyqVs orMatrCr crdi cards.

S;; ouXcla* ahea*ai you WallVnestoldverised aAPrisn costs

forclasiie v itisornastesand deadlifnes.

Multnomah, Ste. 100, Portland, OR 97232-2099. EOE.

t~~ ~ ~~~~~~~~~~~~~~~~~~~'Now Nwim-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

References: 1. Greenberg RN. Overview of patient compliance with medication dosing: a literature review. Clin Ther.1984;6:592-599. 2- RedBook' Update, Montvale, NJ: Medical Economics Co Inc;,UI 1998:.22,24,26,27,71.

ZITHROMAXI(azithromycin for oral suspension)

BRIEF SUMMARY

INDICATIONS AND USAGEZITHROMAX' (azithromycin) is indicated for the treatment of patients with mild to moderate infections (pneumonia:see WARNINGS) caused by susceptible strains of the designated microorganisms in the specific conditions listedbelow. As recommended dosages, durations of therapy, and applicable patient populations vary among theseinfections, please see DOSAGE AND ADMINISTRATION for soecific dosing recommendations,

Acute otitis media caused by 11aemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae.(For specific dosage recommendation, see DOSAGE AND ADMINISTRATION.)

Community-acquired pneumonia due to Chlamydia pneumoniae, Haemophilus influenzae, Mycoplasmapneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy. (For specific dosagerecommendation, see DOSAGE ANO ADMINISTRATION.)

NOTE: Azithromycin should not be used in pediatric patients with pneumonia who are judged to beinappropriate for oral therapy because of moderate to severe illness or risk factors such asany of the following: patients with cystic fibrosis, patients with nosocomially acquiredinfections, patients with known or suspected bacteremia, patients requiring hospitalization,or patients with significant underlying health problems that may compromise their ability torespond to their illness (including immunodeficiency or functional asplenia).

Pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to first-line therapy in individualswho cannot use first-line therapy. (For specific dosage recommendations, see DOSAGE AND ADMINISTRATION.)

NOTE: Penicillin by the intramuscular route is the usual drug of choice in the treatment of Streptococcuspyogenes infection and the prophylaxis of rheumatic fever. ZITHROMAX" is often effective in the eradication ofsusceptible strains of Streptococcus pyogenes from the nasopharynx. Because some strains are resistant toZITHROMAX", susceptibility tests should be performed when patients are treated with ZITHROMAVt Dataestablishing efficacy of azithromycin in subsequent prevention of rheumatic fever are not available.

Appropriate culture and susceptibility tests should be performed before treatment to determine the causativeorganism and its susceptibility to azithromycin. Therapy with ZITHROMAX' may be initiated before results of thesetests are known: once the results become available, antimicrobial therapy should be adjusted accordingly.

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

WARNINGSSerious allergic reactions, including angioedema, anaphylaxis, and dermatologic reactions including StevensJohnson Syndrome and toxic epidermal necrolysis have been reported rarely in patients on azithromycin therapy.Although rare, fatalities have been reported. (See CONTRAINDICATIONS.} Despite initially successfulsymptomatic treatment of the allergic symptoms, when symptomatic therapy was discontinued, the allergicsymptoms recurred soon thereafter in some patients without further azithromycin exposure. These patientsrequired prolonged periods of observation and symptomatic treatment. The relationship of these episodes to thelong tissue half-life of azithromycin and subsequent prolonged exposure to antigen is unknown at present.

If an allergic reaction occurs, the drug should be discontinued and appropriate therapy should be instituted.Physicians should be aware that reappearance of the allergic symptoms may occur when symptomatic therapyis discontinued.

In the treatinent of pneumonia, azithromycin has only been shown to be safe and effective in thetreatment of community-acquired pneumonia due to Chlamydia pneumoniae, Haemophilus infiuenzae,Mycoplasmna pneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy.Azithromycin should not be used in patients with pneumonia who are judged to be inappropriate for oraltherapy because of moderate to severe illness or risk factors such as any of the following: patients withcystic fibrosis, patients with nosocomially acquired infections. patients with known or suspectedbacteremia, patients requiring hospitalization, elderly or debilitated patients, or patients with significantunderlying health problems that may compromise their ability to mpond to their illness (includingimmunodeficiency or functional asplenia).

Pseudomembranous colitis has been reported with nearly all antibacterial agents and may range inseverity from mild to life-threatening. Therefore, it is important to consider this diagnosis in patientswho present with diarrhea subsequent to the administration of antibacterial agents.

Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridia.Studies indicate that a toxin produced by Clostridium difficile is a primary cause of 'antibiotic-associated colitis."

After the diagnosis of pseudomembranous colitis has been established, therapeutic measures should be initiated.Mild cases of pseudomembranous colitis usually respond to discontinuation of the drug alone. In moderate to severecases, consideration should be given to management with fluids and electrolytes, protein supplementation, andtreatment with an antibacterial drug clinically effective against Clostridium difficile colitis.

PRECAUTIONSGeneral: Because azithromycin is principally eliminated via the liver, caution should be exercised when azithromycinis administered to patients with impaired hepatic function.

There are no data regarding azithromycin usage in patients with renal impairment: thus, caution should beexercised when prescribing azithromycin in these patients.

The following adverse events have not been reported in clinical trials with azithromycin, an azalide; however,they have been reported with macrolide products: ventricular arrhythmias, including ventricular tachycardia andtorsades de pointes, in individuals with prolonged OT intervals.

There has been a spontaneous report from the post-marketing experience of a patient with previous history ofarrhythmias who experienced torsades de pointes and subsequent myocardial infarction following a course ofazithromycin therapy.Information for Patients: Patients should be cautioned to take ZITHROMAX(t suspension at least one hour prior toa meal or at least two hours after a meal. This medication should not be taken with food.

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

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

Administration of cimetidine l800 mg) two hours prior to azithromycin had no effect on azithromycin absorption.Azithromycin did not affect the plasma levels or pharmacokinetics of theophylline administered as a single

intravenous dose. The effect of azithromycin on the plasma levels or pharmacokinetics of theophylline administeredin multiple doses resulting in therapeutic steady-state levels of theophylline is not known. However, concurrent useof macrolides and theophylline has been associated with increases in the serum concentrations of theophylline.Therefore, until further data are available, prudent medical practice dictates careful monitoring of plasmatheophylline levels in patients receiving azithromycin and theophylline concomitantly.

Azithromycin did not affect the prothrombin time response to a single dose of warfarin. However, prudent medicalpractice dictates careful monitoring of prothrombin time in all patients treated with azithromycin and warfarinconcomitantly. Concurrent use of macrolides and warfarin in clinical practice has been associated with increasedanticoagulant effects.

The following drug interactions have not been reported in clinical trials with azithromycin; however, no specificdrug interaction studies have been performed to evaluate potential drug-drug interaction. Nonetheless, they havebeen observed with macrolide products. Until further data are developed regarding drug interactions whenazithromycin and these drugs are used concomitantly, careful monitoring of patients is advised:

Digoxin-elevated digoxin levels.Ergotamine or dihydroergotamine-acute ergot toxicity characterized by severe peripheral vasospasmand dysesthesia.Triazolam-decrease the clearance of triazolam and thus may increase the pharmacologic effect of triazolam.Drugs metabolized by the cytochrome P450 system-elevations of serum carbamazepine, terfenadine, cyclosporine,hexobarbital, and phenytoin levels.

Laboratory Test Interactions: There are no reported laboratory test interactions.Carcinogenesis, Mutagenesis, Impairment of Fertility: Long-term studies in animals have not been performedto evaluate carcinogenic potential. Azithromycin has shown no mutagenic potential in standard laboratory tests:

mouse lymphoma assay, human lymphocyte clastogenic assay, and mouse bone marrow clastogenic assay.No evidence of impaired fertility due to azithromycin was found.Pregnancy: Teratogenic Effects. Pregnancy Category B: Reproduction studies have been performed in rats and miceat doses up to moderately maternally toxic dose levels (i.e., 200 mg/kg/day). These doses, based on a mg/m2 basis,are estimated to be 4 and 2 times, respectively, the human daily dose of 500 mg. In the animal studies. no evidenceof harm to the fetus due to azithromycin was found. There are, however, no adequate and well-controlled studies inpregnant women. Because animal reproduction studies are not always predictive of human response, azithromycinshould be used during pregnancy only if clearly needed.Nursing Mothers: It is not known whether azithromycin is excreted in human milk. Because many drugs are excretedin human milk, caution should be exercised when azithromycin is administered to a nursing woman.Pediatric Use: (INDICATIONS AND USAGE.)

Acute Otitis Media (dosage regimen: 10 mg/kg on Day 1 followed by 5 mg/kg on Days 2-5): Safety andeffectiveness in the treatment of children with otitis media under 6 months of age have not been established.

Community-Acquired Pneumonia (dosage regimen: 10 mg/kg on Day 1 followed by 5 mg/kg on Days 2-5): Safetyand effectiveness in the treatment of children with community-acquired pneumonia under 6 months of age have notbeen established. Safety and effectiveness for pneumonia due to Chlamydia pneumoniae and Mycoplasma pneumoniaewere documented in pediatric clinical trials. Safety and effectiveness for pneumonia due to Haemophilus influenzaeand Streptococcus pneumoniaewere not documented bacteriologically in the pediatric clinical trial due to difficultyin obtaining specimens. Use of azithromycin for these two microorganisms is supported, however, by evidence fromadequate and well-controlled studies in adults,

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

Studies evaluating the use of repeated courses of therapy have not been conducted.Geriatric Use: Pharmacokinetic parameters in older volunteers (65-85 years old) were similar to those in youngervolunteers ll8-40 years old) for the 5-day therapeutic regimen. Dosage adjustment does not appear to be necessaryfor older patients with normal renal and hepatic function receiving treatment with this dosage regimen.

ADVERSE REACTIONSIn clinical trials, most of the reported side effects were mild to moderate in severity and were reversible upondiscontinuation of the drug. Approximately 0.7% of the patients (adults and children) from the multiple-dose clinicaltrials discontinued ZITHROMAX1' (azithromycin) therapy because of treatment-related side effects. Most of the sideeffects leading to discontinuation were related to the gastrointestinal tract, e.g., nausea, vomiting, diarrhea, orabdominal pain. Potentially serious side effects of angioedema and cholestatic jaundice were reported rarely.Clinical: Adults: Multiple-dose regimen: Overall, the most common side effects in adult patients receiving amultiple-dose regimen of ZITHROMAX' were related to the gastrointestinal system with diarrhea/loose stools 15%).nausea (3%t, and abdominal pain (3%) being the most frequently reported.

No other side effects occurred in patients on the multiple-dose regimen of ZITHROMAX' with a frequency greaterthan 1%. Side effects that occurred with a frequency of 1% or less included the following:Cardiovascular Palpitations, chest pain.Gastrointestinal: Dyspepsia, flatulence, vomiting, melena, and cholestatic jaundice.Genitourinary: Monilia, vaginitis, and nephritis.Nervous System: Dizziness, headache, vertigo, and somnolence.General: fatigue.Allergic: Rash, photosensitivity, and angioedema.Single 1-gram dose regimerr. 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 inpatients receiving the multiple-dose regimen.

Side effects that occurred in patients on the single one-gram dosing regimen of ZITHROMAX' with a frequency of1% or greater included diarrhea/loose stools 17%), nausea (5%), abdominal pain l5%), vomiting (2%), dyspepsia (11%),and vaginitis (1%).Single 2-gram dose regimen: Overall, the most common side effects in patients receiving a single 2-gram dose ofZITHROMAX' were related to the gastrointestinal system. Side effects that occurred in patients in this study with afrequency of 1% or greater included nausea (18%), diarrhea/loose stools (14%), vomiting (7%), abdominal pain (7%),vaginitis (2%), dyspepsia (11%), 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,with different incidence rates for the two dosage regimens recommended in children.

Acute Otitis Media: For the recommended dosage regimen of 10 mg/kg on Day 1 followed by 5 mg/kg onDays 2-5, the most frequent side effects attributed to treatment were diarrhea/loose stools 12%), abdominal pain (2%),vomiting (11%), and nausea 01%N.

Community-Acquired Pneumonia: For the recommended dosage regimen of 10 mg/kg on Day followed by5 mg/kg on Days 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 mg/kg on Days 1-5, the most frequent sideeffects attributed to treatment were diarrhea/loose stools (6%), vomiting (5%), abdominal pain (3%), nausea (2%),and headache (1%).

With either treatment regimen, no other side effects occurred in children treated with ZITHROMAX-' with afrequency of greater than 1%. Side effects that occurred with a frequency of 1% or less included the following:Cardiovascular Chest pain.Gastrointedinal: 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 adultand/or pediatric patients for which a causal relationship may not be established include:Allergic: Arthralgia, edema, urticaria.Cardiovascular Arrhythmias including ventricular tachycardia.Gastrointestinal: Anorexia, constipation, dyspepsia, flatulence, vomiting/diarrhea rarely resulting in dehydration.General: Asthenia, paresthesia.Genitourinary: Interstitial nephritis and acute renal failure.Liver/Biliary: Abnormal liver function including hepatitis and cholestatic jaundice.Nervous System: Convulsions.Skin/Appendages: Rarely serious skin reactions including erythema multiforme, Stevens Johnson Syndrome, andtoxic epidermal necrolysis.Special Senses: Hearing disturbances including hearing loss, deafness, and/or tinnitus, rare reports of tastedisturbances.Laboratory AbnorTnalities: Adults: Significant abnormalities (irrespective of drug relationship) occurring duringthe clinical trials were reported as follows: with an incidence of 1-2%, elevated serum creatine phosphokinase,potassium, ALT (SGPT), GGT, and AST (SGOT);- with an incidence of less than 1%, leukopenia, neutropenia,decreased platelet count, elevated serum alkaline phosphatase, bilirubin, BUN, creatinine, blood glucose, LDH,and phosphate.

When follow-up was provided, 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 I because of a renal tunction abnormality.Children: Significant abnormalities (irrespective of drug relationship) occurring during clinical trials were allreported at a frequency of less than 1%, but were similar in type to the adult pattern.

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

Pediatric Health

-~~~~~~~~~~~~~~~.......l I 1O-I ii : I0L~

L

(voice & fax). Visit the Lloyd Noland CMEWeb site: http://www.lloydnolandcme.org.

ALOHA UPDATE: PEDIATRICS 1999 -BigIsland of Hawaii, Oct. 23-29, 1999.University Childrens Medical Group and AAPCalifornia Chapter 2. For more informationcontact: Bernadette Serran or Laura Thomas,6430 Sunset Blvd., Ste. 600, Los Angeles,CA 90028. 1-800-3-kid-cme or (323) 669-2305. E-mail: IthomasUchla.usc.edu. Website: http://www.ucmg.org.

THE CLEVELAND CLINIC FOUNDATIONDEPARTMENT OF PEDIATRICS presentsPEDIATRIC BOARD REVIEW -Aug. 30 -

Sept. 3, 1999. Bunts Auditorium, Cleveland,Ohio. For further information, please contactthe Continuing Medical EducationDepartment at: (216) 444-5696 (local),(800) 862-8173 (toll free), or (216) 445-9406 (fax).

ADVERSE EVENTS in patients following expo-sures to insect repellents containing DEET.The National DEET Registry was establishedin 1995 to study patients who report anadverse event, primarily CNS or a systemiceffect, associated with the use of N, N-Diethyl-m-toluamide (DEET). PEGUSResearch, Inc., an independent research com-pany in Salt Lake City, Utah, is seeking infor-mation from health care professionals regard-ing patients who may have experienced suchan event. With their consent, patients will beasked to participate in a telephone interviewconducted by PEGUS staff. If you would likemore information about the registry or if youare involved in the treatment of a patientexposed to DEET and experiencing anadverse event, please call Dr. Brent Page orStefanie Petersen at PEGUS Research (800)949-0089.

OCTOBER

Pediatrics for the Practitioner" -Big Island,Hawaii, Oct. 11 -14,1999. Sponsored by St.Luke's Hospital and the Children's MercyHospital of Kansas City. Call (816) 932-2220or send e-mail to cme?saint-lukes.org forinformation.

Pediatric Infectious Disease Seminar -(1 1 thAnnual Lloyd Noland), at the WyndhamPalace, Walt Disney World, Florida, Oct. 20-23, 1999. Faculty: Drs. Chadwick, Chesney,Lieberman, Littman and Rennels. Call, fax orwrite: George M. Converse 111, M.D., FAAP,Department of Medical Education, LloydNoland Foundation, P.O. Box 925 Fairfield,AL 35064-0925. Phone: (205) 783-5276

ZC21 9A98(C 1998, Pfizer Inc

July 1999 AAP News 35

O;rde ri n ,,,Cftpdori;lni.od:rfreonn 0o if-0:artkts

D e4st t ntA .

Villige~~~~~~IL 6 7 ''092

EV.inal...EdhdffiAhft

COVERAGE OF KEY RESPIRATORY PATHOGENS

T Y P I C A L A T Y P I C A LStreptococcus pneumoniae Chlamydia pneumoniaeHaemophilus influenzae Mycoplasma pneumoniaeMoraxella catarrhalisl

* BETTER COMPLIANCE MAY IMPROVE PATIENT OUTCOMES'* COSTS LESS THAN MOST BRAND-NAME ANTIBIOTICS'* PROVEN TOLERABILITY

In acute otitis media, the most common side effects are diarrhea/loose stools (2%), abdominal pain (2%),vomiting (1 %), and nausea (1 %). In community-acquired pneumonia, the most common side effects arediarrhea/loose stools (5.8%), abdominal pain, vomiting, and nausea (1.9% each), and rash (1.6%).ZithromaxO (azithromycin for oral suspension) is contraindicated in patients with known hypersensitivityto azithromycin, erythromycin, or any macrolide antibiotic.

Zithromax is indicated for pediatric infections such as acute otitis media due to H influenzae, M catarrhalis, orS pneumoniae, and community-acquired pneumonia due to C pneumoniae, H influenzae, M pneumoniae, orS pneumoniae.Oral azithromycin should not be used in pediatric patients with pneumonia who are judged to be inappropriatefor oral th'erapy because of moderate to severe illness or risk factors such as any of the following: patients withcystic fibrosis, patients with nosocomially acquired infections, patients with known or suspected bacteremia,patients requiring hospitalization, or patients with significant underlying health problems that may compromisetheir ability to respond to their illness (including immunodeficiency or functional asplenia).

o once-d~~~ail oe(ficy tht' easy Io you iteptinst take

Please see brief summary of prescribinginformation on adjacent page.