amikacin liposome inhalation suspension + azithromycin + ethambutol

This is a **combination drug regimen** consisting of three antibiotics: - **Amikacin liposome inhalation suspension** (a liposomal formulation for inhalation; brand name Arikayce) - **Azithromycin** (an oral macrolide antibiotic) - **Ethambutol** (an oral antimycobacterial agent) This regimen is primarily used in adults for the treatment of refractory Mycobacterium avium complex (MAC) lung disease, notably when standard multidrug therapy has failed to achieve culture conversion[2][4][5][7]. Amikacin liposome inhalation suspension (ALIS/Arikayce) is administered by oral inhalation and delivers amikacin directly to the lungs, enhancing local effects and reducing systemic toxicity[1][2][4][5]. Azithromycin and ethambutol are oral agents that act as backbone drugs against MAC; their combination shows limited bactericidal activity and rapid emergence of resistance, but amikacin liposome acts as an adjunct to improve outcomes[2][3][5]. The mechanism of action for amikacin is inhibition of bacterial protein synthesis via binding to the 30S ribosomal subunit; azithromycin binds to the 50S subunit to inhibit protein synthesis; ethambutol disrupts mycobacterial cell wall synthesis by inhibiting arabinosyl transferase enzymes. This regimen is standard for refractory or persistent MAC lung disease for patients who do not clear infection on guideline-based oral therapy[2][3][4][5][7].

Brand names

Arikayce

Other names

LAI plus multi-drug regimenLiposomal Amikacin for Inhalation plus multi-drug regimenARIKAYCE plus multi-drug regimen