SUMMARY

In some serious lung infections, including nontuberculous mycobacterial (NTM) lung infections, the bacteria can invade and multiply intracellularly within macrophages. The presence of an intracellular pathogen can make it more difficult for inhaled antibiotics to be effective if the drug is unable to access the intracellular compartment to an adequate extent. When non-liposomal amikacin is delivered via inhalation, the drug concentration in the lung falls significantly over the 24-hour period due to clearance and absorption from the lung [1]. The development of resistance may result when the drug concentrations fall below the pathogen’s minimum inhibitory concentration (MIC).