@marmee26 That's a great question. It will be interesting to here what other members have to say. I recently learned that there is an amikacin liquid available that can be placed in the nebulizer, which might be more effective than the oral version. Arikayce is a specially formulated liposomal version of Amikacin, but for many people it is expensive. If you are not on Medicare, Medicaid or VA assistance, you may be eligible for help to pay for Arikayce.