CLASSIFIED ADVERTISING POLICY Although the Academy believes these classified ads are from reputable sources, the Academy Clasfcto: Classified ads are accepted under Business Services, GenemalAmdoes not investigate the offers made and assumes no responsibility concerniing diem. Medical Meetings, Physicians Wanted, Positions Wanted, Practices Available, Pu

Q_i 0b 3S 3 W ' l 2 i X Occassionally, it is necessary to modify the wording of claissified ads. T'hese changes are gener- RelEteanRsind/Flo hpAvlbe.~~~~~~~~~~~~~~lybbWihtergkldnsbfjarortdabigudwuriofcDisplay C ssifiedAd: Cmr-edy, 4-coor 3-color and 2 color display cu

XU

ihacpe mfsinlsadrs fmdclpade Wanted, Practices Available anld Residencies/ Fellowships Available. Contactj z z m.atf-~~~~~~~~~~~~~~~~These adverdsing modifications are made to maintain a classified section that is professionally display classifed ad sizes and rates.

; = = 3 | g ~~~~~~~~~~~~~~~~~responsible, lawful, scientific and free of discrimination. Pubfication of an advertisement int-~~~~~~~~~~~~~~~~~~~~~A Ne_w>

AD)S BY E-MAILAAP News can now accept yourdassified advertising by e-mail!Send ads to ppetersen@aap.org

0

BridgesTo Rea ing9A° of all parents ask their .Now, when your patientsdoctor for answers when .ask you for help, you havethey suspect their child a tool to recommend:has a reading problem.'. BridgesTo ReadingTN

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Take the latest in medical services, add a staffof regionally-renowned professionals supported by a newly renovated,state-of-the-art facility, and place them in one of the most scenicareas of the country. The result: a window of opportunity for thepediatrician seeking both career and lifestyle enhancements.Johnston Memorial Hospital, a 135-bed acute c:are facility located inth-e heart of southwest Virginia, offers an enticing blend of profes-sional challenge and personal enrichment. From our antebellumdowntown district to the sprawling Appalachian Mountains embrac.ing our community, you'll discover more than juist a position inAbingdon... you'll find a place you'll want to call home.We currently seek pediatricians for an outstanding practiceopportunity affiliated with our hospital. For more information, pleasecontact Deborah J. Bourne, Director of Physician Services at

Calln~80 4 94 to ordera BridgesTo Reading - kit for your office

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This prqjea ws devloed by te Parents'Ed6catbrod Resurce Center (PERC) and undenvrittenby te OwrAes anid Helen Schwab h;undtion,a nonprofit foundw;o dedicatd to knprnwg thlelive ofchddren wit earning diffierences. *Tan *O a I S IPrtWOaf

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KentuckyBC/BE Pediatrician -needed to joinrapidly growing, well established pedi-atric group located forty-five minutesfrom metropolitan Louisville, Ky. Exoel-lent call schedule with competitivesalary and benefits package. Mail CVto Physician Recruitment Coordinator,P.O. Box 35070, Louisville, KY 40232-5070. Phone (800).243-2984 or fax(502).629-2488.

MarylandIntegrated Health System-nearDC/Baltimore seeks BE/BC pediatri-cian to join multi-specialty system. 1/5call; productivity bonus. Dr. P. Jacobs,E.J. Michaels Ltd. (800) 333-2999;(914) 833-1700 or fax (914) 833-1711.

New JerseyBC/BE pediatrician to join dynamicgroup, N.W. Bergen County. Level IINeonatal Care. Salary leading to earlypartnership. Mail CV to AAP News,Box # 06016, 141 Northwest PointBlvd., Elk GroveVillage, IL 60007.

Boston IndianaLogansport, Indiana -is the placeyou'll want to join a successfulpediatrics practice with excellentincome in a new Medical Office Build-ing. This family-oriented communitybetween Chicago and Indianapolisoffers the charm of the Midwest witha progressive spirit. For immediateconsideration call Elaine Hall at (800)243-451 2.

April

Annual Chapter Meeting -Minneso-taVI annual meeting, April 19,1997.For further information contact JuliePierce, 1847 N.W. 131st Lane, Min-neapolis, MN 55448. (612) 757-7805.

June

Practicing Pediatrfics in the Good Ol'Summertime -June 19-21, 1997, TheCloister Resort, Sea Island, Ga. Spon-sor: American Academy ofPediatrics/Georgia Chapter. Clinical top-ics in general pediatrics, plus seminar onpractice management. CME creditoffered. For information, oontact: LouisePringle-Jones (404) 881-5094; fax (404)249-9503; ore-mail: louiseRmag.org.

40th Annual Pediatric Program andAnnual Meeting Colorado AAP-June 25-28, 1997; PALS Course, NRPProvider, Renewal, and InstructorCourse at The Denver Children's Hos-pital. (303) 372-9050; (800) 882-9153.

July

Children's Hospital, Boston, Divi-sion of General Pediatrics. Fellow-ship programs in: General AcademicPediatrics, Developmental-BehavioralPediatrics, Developmental Disabil-ities, Primary Care Research, andPediatric Health Services Researchare now open to application. Call forinformation at (617) 355-6714, Fax:(617) 355-7940. Applications shouldbe sent to Judith Palfrey, M.D., Chief,Division of General Pediatrics,Children's Hospital, 300 LongwoodAve., Boston, MA 02115. e-mail:Palfreyi?A1l.Tch.Harvard.Edu

Gundersen Lutheran is currently seeking a Primary CarePhysician with strong Pediatric background. Physician willpractice in Urgent Care Clinic, which serves children needingnon-emergency care. Physician will work a rotating schedulewith other Urgent Care and Emergency Medicine physicians.Gundersen Lutheran is a multi-specialty group practice withover 300 physicians. Its main campus is adjacent to an affiliated402-bed acute care hosptial. The Gundersen system includes 36regional community clinics based throughout westernWisconsin, eastern Minnesota, and northeastern Iowa.La Crosse, Wisconsin, nestled among towering bluffs, is locatedwhere the Mississippi, La Crosse and Black Rivers merge. Thearea was untouched by the glaciers, leaving many hills andvalleys as an outstanding scenic area. The metropolitan area ofLa Crosse, with its 100,000 people, offers exceptional year"round opportunities for recreational activities.We offer competitive salaries and excellent fringe benefits.Interested candidates should send a letter of application andcurriculum vitae to Frank Perez-Gueffa, Manager, Recruitment,Retention and Resource Planning, Gundersen Clinic, Ltd., 1836South Avenue, La Crosse,WI 54601;or call 1-800- nln erseri362-9567, ext. 6325. ACht"l

"Management of CommonPediatric Problems" -July1 0 - 12,1 997, Hilton of SantaFe, Santa Fe, New Mexico.Featured speakers: PaulDworkin, M.D., FAAP, Behav-ior and Development; RonaldHansen, M.D., FAAP, Derma-tology. Contact UNM Office ofContinuing Medical Educa-tion, Campus Box 713,Albuquerque, NM 87131-5126; phone (505) 72-3942;fax (505) 272-8604.

L-AL --JIL-

AugustTHE 20TH INTERNATIONAL CON-FERENCE ON PEDIATRIC/ADULTALLERGY AND CLINICAL IMMUNO-OGY - August 1-3,1997, FourSeason's Hotel, Toronto, Ontario,Canada. Sponsored by Sunyab; 14hours, Category I, AMA and AAFPCredit. Contact Jackie. Phone (716)878-7105; fax (716) 871-0413.

Equal Opportunity Employer

This comprehensiye kit includes:> 8 booklets Pilled with strategies to identify, understand,

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CHLA1RGE ITYou can now chargeyour AAP News dassifiedadvertising costs onyour Visa or MasterCardcredit cards.

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April1997MAPNews 37

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The Department of Pediatrics at Gundersen Clinic, Ltd., iscurrently recruiting a full-time Pediatric Hematologist/ Oncologistfor summer/fall 1997. Our current Pediatric Hem'atologist/Oncologist will be retiring December 31, 1997. We are afffliatedwith the Children's Cancer Group and we are a funded satellitecenter of the Great Lakes Hemophilia Center. A universityacademic affiliation for this position is available.The Department of Pediatrics consists of seventeen pediatricians,six nurse practitioners, three neonatal nurse practitioners, onephysician assistant and a nurse clinician in pediatrichematology/oncology Subspecialties include pediatric orthopaedicsu-rgery, pediatric neurology, pediatric surgery, pediatricophthalmology, pediatric anesthesiology, pediatric intensive careand neonatology.Gundersen Clinic' Ltd., is a multi-specialty group practice withover 300 physicians. Our main campus is attached to an afffliated402-bed acute care hospital with a Level Im Neonatal ICU and aPediatric ICU. The Gundersen Clinic, Ltd., system includes 36regional community clinics in western Wisconsin, easternMfinnesota and northeastern Iowa.We offer competitive salaries and excellent fringe benefits.Interested candidates should send a letter of applicatidn andcurriculum vitae to Frank Perez-Gueffa, Manager, Recrutment,Retention and Resource Planni-ng, Gundersen Clinic, Ltd., 1836South Avenue, La Crosse, WI 54601 < d r eor call 1-800-362-9567, extension h6325. Carefor tbe wayyou Itve.Equal Opportunity Employer

New Mexico

Rocky Mountains, Northern NowMexico -Third BC/BE pediatrician tojoin 4 providers (2 PAs) for every 5thnight call; flexible schedule; qualitycare and dedicated office staff. Casuallifestyle. Low-cost living in a charmingcommunity close to skiing, hiking, fish-ing. Home of Highlands University andUnited World College. Not J-1 visa eli-gible. Santa Fe (1 hour), Albuquerque(2 hours). Contact George Bunch,M.D. / Karen Sterling, M.D., 501 7thStreet, Las Vegas, NM 87701; (505)425-3566.

OregonSalem - Pediatrics: Northwest Per-manente, P.C., a stable, phys-ician-managed multispecialty groupserving 410,000 members of KaiserPermanente in Oregon and southwestWashington, has a half-time positionavailable for a BCIBE general pediatri-cian in Salem, Ore. Our 75-physicianmultispecialty group in Salem, a mid-sized city of 120,000 people located inthe lush Willamette Valley, provides afull range of professional services to43,000 plan members in the area. Weoffer a collegial and stimulating prac-tice in one of the most successfulmanaged care systems in the country,plus a quality lifestyle inherent to thePacific Northwest. We have a compet-itive salary and benefits packageincluding a generous retirement pro-gram, professional liability coverage,sabbatical leave and more. To receiveadditional information, forward inquiryand CV to A.P. Weiland, Regional Med-ical Director, Northwest Permanente,P.C., 500 N.E. Multnomah, Suite 100,Portland, OR 97232-2099. EOE.

~~~~Attn: Joe M. Sanders, Jr., MDt 5) ~American Academy of Pediatrics

0PO Box 927

American El Gov092ae7IAcademy of 6 902Pediatrics EOE M/F/D/V

n

IDEAS FOR LIVING., INC. BOULDER, COLORADO 80304

38 AAP News April 1997

E AxnE_x_w7-iRCT R Ea__ __ _ IO__W

The American Academy of Pediatrics is seeking candidates forthe position of Director, Department of Education. The incumbentwill be responsible for the planning, development, coordinationand administration of all aspects ofAAP professional educationalprograms.

Qualified candidates must be Fellows of the AAP, have experi-ence in medical education and administration, and a broadunderstanding of pediatrics. Excellent communication, organiza-tional, and problem solving skills, and familiarity with AAPprograms are prerequisites. Knowledge of CMIE programs, accred-itation processes, meeting man'agement, and the residency reviewprocess is prefeffed. Experience with educational needs assess-ment and program development, as well as familiarity withcomputers and other technology is desired.

The position is based at the AAP offices in Elk Grove Village,Illinois.

Applicants, cuffent cufficulum vitae and salary requirementsshould be submitted prior to April 30, 1997 to:

"I'd thtought not,hitn4g coul wvake oursitx year ol son. But whven a urologistrecommnencded thzePotty Pager, wedfecidaed to grive it a try. Thtree wteekslter our son' bedwvettringr problenms

wvere over!Jan Van Hoffo

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ZITHROMAIXO (ozithromycl for oral suspension)BIRIEF SUIMMA^RY

INDICATIONS AND USAGEZITHROMAXS {azithromycin) is indicated for the treatment of patients with mild to moderate infections caused by susceptiblestrains of the designated microorganisms in the specific conditions listed below. As recommended dosages. durations of therapy,and applicable patient populations vary among these infections, please see DOSAGE AND ADMINISTRATION for specificdosing recommendations.Children:Acute otitis media caused by Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae. (For specific

dosage recommendation, see DOSAGE AND ADMINISTRATION.)Pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to first line therapy in individuals who cannot use

first-line therapy. (For specific dosage recommendation, see DOSAGE AND ADMINISTRATION.)NOTE: Penicillin by the intramuscular route is the usual drug of choice in the treatment of Streptococcus pyogenes infection and

the prophylaxis of rheumatic fever. ZITHROMAXII is often effective in the eradication of susceptible strains of Streptococcuspyogenesfrom the nasopharynx. Because some strains are resistant to ZITHROMAXS, susceptibility tests should be performedwhen patients are treated with ZITHROMAXM. Data establishing efficacy of azithromycin in subsequent prevention of rheumaticfever are not available.Appropriate culture and susceptibility tests should be performed before treatment to determine the causative organism and its

susceptibility to azithromycin. Therapy with ZITHROMAXS may be initiated before results of these tests are known; once theresults become available, antimicrobial therapy should be adjusted accordingly.

CONTRAINDICATIONISZITHROMAXO is contraindicated in patients with known hypersensitivity to azithromycin, erythromycin, or any macrolideantibiotic.

WARNINGSSerious allergic reactions, including angioedema and anaphylaxis, have been reported rarely in patients on azithromycin therapy.(See CONTRAINDICATIONS.) Despite initially successful symptomatic treatment of the allergic symptoms, when symptomatictherapy was discontinued, the allergic symptoms recurred soon thereafter in some patients without further azithromycinexposure. These patients required prolonged periods of observation and symptomatic treatment. The relationship of theseepisodes to the long 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 beaware that reappearance of the allergic symptoms may occur when symptomatic therapy is discontinued.Pseudomembranous colitis has been reported with nearly all antibacterial agents and may range in severity from mild to life-

threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea subsequent to theadministration 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 severe cases, considerationshould be given to management with fluids and electrolytes, protein supplementation, and treatment with an antibacterial drugclinically 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 renalimpairment; thus, caution should be exercised when prescribing azithromycin in these patients.The following adverse events have not been reported in cliplical trials with azithromycin, an azalide; however, they have been

reported with macrolide products: ventricular arrhythmias, including ventricular tachycardia and torsades de pointes, inindividuals with prolonged OT intervals.There has been a spontaneous report from the post-marketing experience of a patient with previous history of arrhythmias who

experienced torsades de pointes and subsequent myocardial infarction following a course of azithromycin therapy.Information for Patients:Patients should be cautioned to take ZITHROMAX0 suspension at least one hour prior to a meal or at least two hours after ameal. This medication should not be taken with food.Patients should also be cautioned not to take aluminum- and magnesium-containing antacids and azithromycin simultaneously.The patient should be directed to discontinue azithromycin immediately and contact a physician if any signs of an allergic

reaction 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 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 administered in multiple doses resulting intherapeutic steady-state levels of theophylline is not known. However, concurrent use of macrolides and theophylline has beenassociated with increases in the serum concentrations of theophylline. Therefore, until further data are available, prudent medicalpractice dictates careful monitoring of plasma theophylline levels in patients receiving azithromycin and theophyllineconcomitantly.Azithromycin did not affect the prothrombin time response to a single dose of warfarin. However, prudent medical practice

dictates careful monitoring of prothrombin time in all patients treated with azithromycin and warfarin concomitantly. Concurrentuse 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 drug interaction

studies have been performed to evaluate potential drug-drug interaction. Nonetheless, they have been observed with macrolideproducts. Until further data are developed regarding drug interactions when azithromycin and these drugs are used concomitantly,

L.

PennsylvaniaChief, Section of Neonatology-Southeastern Pennsylvania: Full-timeclinicianleducator/administratorsought to lead 2-physician/2-NNPdepartment. Large, university-affiliat-ed medical center with FTperinatologist; 2,700+ births. NewLevel II + NICU with 22 beds, 400admissions. BC neonatologist withdemonstrated leadership experience,managed care knowledge and interestin hands-on role. Confidentiallyrespond to Joan at Longshore & Sim-mons, 625 Ridge Pike, Suite 41 0,Conshohocken, PA 19428; fax (610)941-2424; (800) 346-8397.

Inpatient Pediatrics -PhiladelphiaArea: CHOP Connection, a series offour community hospital inpatient unitsmanaged by The Children's Hospital ofPhiladelphia, has openings for twoinpatient pediatricians to join its grow-ing network. These positions offer awealth of opportunities in clinical care,teaching, as well as administrativedevelopment. Highly competitivesalary and benefits. These positionsdo not qualify as J-1 visa eligible. Formore information, please contact:Catherine Palmier, M.D., Director,Community Inpatient Pediatrics, TheChildren's Hospital of Philadelphia,34th and Civic Center Blvd., Philadel-phia, PA 19104; (215) 590-1953 ore-mail: palmierEemail.CHOR.edu.

VirginiaNorthern Virginia -Thriving pedi-atric practice in Sterling, Va., with areputation for excellence, looking forBC/BE pediatrician to add to our team.Approximately thirty minutes west ofWashington, DC, just minutes from thescenic rural countryside of the BlueRidge Mountains. Many cultural andrecreational opportunities; excellentneighborhoods and schools. Positionis available now with a flexible startingdate. Flexible hours, competitivesalary/benefits package. Please con-tact Shara Messick at (703) 1444-2100or 444-3245, or send CV to PediatricHealthCare, PC, 46440 Benedict Dr.,#207, Sterling, VA 20164.

Wisconsin

Baraboo -Everything you trained foras a pediatrician (except ventilatormanagement)! Attend high risk deliv-eries, ER resuscitations, act as aconsultant, yet see your own patientsfor well-child and sick visits. BC/BEPediatrician needed to join anotherpediatrician in a multispecialty group.Baraboo is a small town in beautifulsouth central Wisconsin, 45 minutesnorth of Madison. Level II nursery, 80-bed hospital with regular subspecialistvisits. ER covered 24 hours. Opportu-nity for resident teaching. Competitivesalary and benefits; possible financialassistance for practice developmentavailable to eligible physicians. Mailinquires and CV's to Scott Lindblom,Dean Medical Center, 1808 West Belt-line, Madison, WI 53715; or call (608)250-1550 or (800) 279-9966; or fax(608) 240-1441.

Weight Loss and Fitness for Kids-For over 25 years Camp Kingsmonthas been helping girls and boys ages7-17 learn about proper fitness andweight control, as well as lifestylechanges. Sessions run 1-8 weeks. Thecamp is located in the BerkshireMountains of Western Mass. For infor-mation for your patients, call (800)854-1 377.

Mid-South -Neonatologist: SeekingBC/BE neonatologist for level 11 +NICU in mid-south region. Thoseinterested send CV to: Issac John,M.D., 6005 Park Ave., Suite 306,Memphis, TN 381 19, or contact sameat (901 ) 685-9640; fax (901 ) 685-9647.

'day),50 mg/day)

rengths

0 DOSAGE GUIDELINES:-Day 1: 10 mg/kg once (not to exceed 500 mg/-Days 2-5: S mg/kg once per day (not to exceed 2.

Cl Available in 100 mg/5 mL and 200 mg/5 mL sti

References: 1. Data on file. Pfizer Inc, New York, NY. 2. McLinn S, Williams D. High incidence ofStretoP1coccus pntumoiniae and Haemophiiltis in'fluenzae (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. AntimicrovbAgents 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 1 5-membered-ringmacrolide wvith improved potency against gram-negative org-anisms. Antimicro)b Agents Chernother.1987;31:1939-1947. 5. McLinn S. Double blind and open label studies of azithromycin in themanagement of acute otitis media in children: a review. Pediati- Infect DisJ. 1995,14:S62-S66.6. Khurana C, McLinn S, Block S, Pichichero M. Trial of azithrornycin (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.

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 F,450 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 to evaluatecarcinogenic 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 toazithromycin was found.Pregnancy: Teratogenic Effects. Pregnancy Category B: Reproduction studies have been performed in rats and mice at doses upto moderately maternally toxic dose levels (i.e., 200 mg/kg/day). These doses, based on a Mg/M2 basis, are estimated to be 4 and2 times, respectively, the human daily dose of 500 mg. In the animal studies, no evidence of harm to the fetus due to azithromycinwas found. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproductionstudies are not always predictive of human response, azithromycin should 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 excreted in humanmilk, caution should be exercised when azithromycin is administered to a nursing woman.Pediatric Use:Acute Otitis Media: Safety and effectiveness in the treatment of children with otitis media (dosage regimen: 10 mg/kg on Day

followed by 5 mg/kg on Days 2-5) under 6 months of age have not been established.Pharyngitis/Tonsillitis: Safety and effectiveness in the treatment of children with pharyngitis/tonsillitis (dosage regimen:

12 mg/kg on Days 1-5) under 2 years of age have not been established.Studies evaluating the use of repeated courses of therapy have not been conducted.

Geriatric Use: Pharmacokinetic parameters in older volunteers 165-85 years old) were similar to those in younger volunteers(118-40 years old) for the 5-day therapeutic regimen. Dosage adjustment does not appear to be necessary for older patients withnormal renal and hepatic function receiving treatment with this dosage regimen.

ADERSE REACTIONSIn clinical trials, most of the reported side effects were mild to moderate in severity and were reversible upon discontinuationof the drug. Approximately 0.7% of the patients (adults and children) from the multiple-dose clinical trials discontinuedZITHROMAXS (azithromycin) therapy because of treatment-related side effects. Most of the side effects leading todiscontinuation were related to the gastrointestinal tract, e.g., nausea, vomiting, diarrhea, or abdominal pain. Potentially seriousside effects of angioedema and cholestatic jaundice were reported rarely.Clinical:Children:Multiple-dose regimens: The types of side effects in children were comparable to those seen in adults, with different incidencerates 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, the most

frequent side effects were diarrhea/loose stools 12%), abdominal pain 12%), vomiting 11%), and nausea (11%).Pharyngitis/tonsillitis: For the recommended dosage regimen of 12 mg/kg on Days 1-5, the most frequent side effects were

diarrhea/loose stools 16%), vomiting 15%), abdominal pain 13%), nausea 12%). and headache (11%).With either treatment regimen, no other side effects occurred in children treated with ZITHROMAXS with a frequency of greater

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 lotitis media dosage), hyperkinesia, dizziness, agitation, nervousness, insomnia.General: Fever, fatigue, malaise.Allergic: Rash.Special Senses: Conjunctivitis.Laboratory Abnormaliities:Children:Significant abnormalities (irrespective of drug relationship) occurring during clinical trials were all reported at a frequency of lessthan 1%, but were similar in type to the adult pattern.

In multiple-dose clinical trials involving almost 3000 pediatric patients, no patients discontinued therapy because of treatment-related abnormalities.

DOS"GE AND ADZINISTRATONChildren:Acute Otitis Media: The recommended dose of ZITHROMAX0 for oral suspension for the treatment of children with acute otitismedia is 10 mg/kg as a single dose on the first day (not to exceed 500 mg/day) followed by 5 mg/kg on days 2 through 5 (not toexceed 250 mg/day).Pharyngitis/Tonsillitis: The recommended dose for children with pharyngitis/tonsillitis is 12 mg/kg once a day for 5 days (not toexceed 500 mg/day).ZITHROMAX(t for oral suspension should be given at least I hour before or 2 hours after a meal.ZITHROMAX'v for oral suspension should not be taken with food.

More detailed professional information available on request.

Issued October 1995

(az trom cin forroral suspension)

Lain NHO Pratt *Roer4* Specialty025A96 la U.S. PharmaceuticalsGroup(B 1996, Pfizer Inc zcc

April 1997 AAP News 39

Access the best in pediatrics...

5-DAY,, ONCE-DAILY THERAPY for acute otitis media

The antibiotic solutionwith predictable results inunpredictable patients

Predictable Coverage ofKey Pathogens:

H influenzae, S pneumoniae, andAM catarrhalis 1-4

Predictable Results:

Proven as effective asAugrnentin", ','0

Predictable Convenience:

The only 5-day, once-dailytreatrnent

Predictably VVell Tolerated:

Only 0.3% discontinuation dueto side effects

The most frequent side effects arediarrhea/loose stools (2%), abdominal pain (2%),vomiting (1%), and nausea (1%). ZithromaxO

(azithromycin) is contraindicated in patients withknown hypersensitivity to macrolides.

(uihoyi fo

Please see brief summary of prescribing information on adjacent page.

TH E PREDICTABILITY YOU N EED I N PEDIATRICS .

THE ONLY 5-[)AY,,O)NCE- DAILY TrHERAPYF'OR AkCUTE OTITIS

IVEDIA