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Arikayce (amikacin liposome inhalation suspension) is a liposomal formulation of the aminoglycoside antibiotic amikacin, specifically designed for oral inhalation via a nebulizer. Developed by Insmed Incorporated, the drug utilizes a proprietary liposomal technology (Pulmovance) to deliver high concentrations of amikacin directly to the lungs while minimizing systemic exposure and associated toxicities such as ototoxicity and nephrotoxicity. The liposomes are designed to be taken up by alveolar macrophages, the primary site of infection for nontuberculous mycobacteria (NTM), and to penetrate bacterial biofilms. It is FDA-approved for the treatment of refractory *Mycobacterium avium* complex (MAC) lung disease as part of a combination antibacterial regimen. Additionally, it has been investigated in Phase 2 clinical trials, such as those led by Kevin Winthrop, for the treatment of *Mycobacterium abscessus* lung disease, a particularly difficult-to-treat form of NTM infection.
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