I believe that Amikacin can be delivered by nebulizing. My doctor’s office did say that Azithromycin should not be taken alone, due to resistance developing, and that this is one of the main reasons for using a cocktail of multiple drugs. There is now a large clinical trial of 2 vs 3 additional drugs used concurrently with Azithromycin. It involves adding either Ethambutol or Ethambutol and Rifampin. Rifampin has been shown to lower blood levels of Azithromycin, and many patients do just as well with only the Ethambutol added. The study trial is ongoing. My doctor said that, while they once worried about using only 2 drugs, having Amikacin to add after 6 months, if culture conversion has not been reached, is a game changer.

I was told to take the one tablet of Azithromycin together with all three tablets of Ethambutol together right before bed and just sleep. I have been doing that with no issues. I take them on an empty stomach for better absorption.

Every morning, I take a very good probiotic strain with 25 billion plus an additional one with saccharomyces boulardi and another of rhamnosus. I take these a couple of hours before eating. Although I had loose stools while on Clofazimine only, my stools and BMs are completely normal on the new regimin. Maybe try this. Each of us is different, and I have been on this for less than a month, but it may help you.