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IV-Amikacin or Arykace or Both--Which Order?
I have had Bronchiectasis for many years and MAC on and off. Originally diagnosed in 2011. I started taking Azithromycin and Ethambutol in 2021 (could not tolerate Rifampin) when my CT scans showed some deterioration. About a year and a half ago I developed a cavity. For the last 9 months i have not been able to clear the MAC and have stayed positive. That is a change from before. I have had many sputum tests. And so now, I have been advised (mostly) that in this situation I need to go on the IV for 2 months and then Arikayve to clear the infection. One Dr said you might do just as well on going to Arikayce first. And so this is the question: What is everybody's experience with the IV? I know the most significant side effect is hearing. I don't know much more. Has anybody with a cavity just gone on Arikayce first and what your results? What are people's experience with the IV? I am very concerned going that route but it may be best. I want to continue exercising (pickleball) and not sure if I'll be able to. Thank you for your input.
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@ddemark01 I was diagnosed with cavitary MAC in 2024 and put on Azithromycin, Ethambutol, Rifampin and IV Amikacin. After only 2 weeks, I was told that the Amikacin was not susceptible so it was stopped and I was then put on Arikayce. IV Amikacin is stronger and can be harder on the body for sure but your doctor should closely monitor you. From what I have read and been told it can be very effective and is typically first line with the big 3. Personally, I would go with the IV in the hopes that it can really knock it down and then Arikayce can be added later.