Inhaled Amikacin Combination Improves MAC Culture Conversion With Rare Resistance in ENCORE
In the phase 3b ENCORE trial, adding amikacin liposome inhalation suspension to azithromycin and ethambutol led to significantly better culture conversion in patients newly diagnosed with MAC lung disease. Resistance emerging during treatment was rare for amikacin (2.2%) and macrolides (1.1%). Kevin Winthrop, MD, shared insights on the findings.
Treatment of infectious disease often involves balancing regimen effectiveness against resistance. In the ENCORE phase 3b trial, adding amikacin liposome inhalation suspension to azithromycin and ethambutol was linked to better culture conversion in newly diagnosed MAC lung disease. Resistance emerging during treatment was rare for amikacin (2.2%) and macrolides (1.1%). Kevin Winthrop shared insights on the findings.
People newly diagnosed with MAC lung disease could be affected if this regimen changes treatment discussions, especially where culture conversion and resistance suppression are priorities. Clinicians and health systems may need to consider inhaled administration, monitoring, and access. The findings may support antimicrobial stewardship by drawing attention to resistance during combination therapy, but they do not establish long-term outcomes or widespread societal benefit.