{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T09:47:26Z","timestamp":1793526446559,"version":"4.5.0"},"reference-count":27,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Intravenous amikacin, recommended for severe or recurrent M. avium complex (MAC) infections and as initial treatment for M. abscessus lung disease, is often limited by serious adverse effects such as renal and auditory toxicities. Inhaled Amikacin Liposome Inhalation Suspension (ALIS) enhances pulmonary drug deposition while minimizing systemic adverse effects, and it has recently been introduced as an add-on therapy for refractory MAC infections or when other standard treatments are inadequate. This study aims to retrospectively describe the outcomes of Greek patients with difficult-to-treat non-tuberculous mycobacterial (NTM) lung disease following the addition of ALIS to guideline-based therapy. Materials and Methods: Seventeen consecutive patients (median age: 66 years) treated with ALIS as an add-on therapy to a standard regimen at \u201cSotiria\u201d General Hospital of Chest Diseases (Athens, Greece) from 2020 to 2023 were enrolled in this study. These patients had recurrent or refractory NTM lung disease and\/or limited treatment options due to prior treatment-related adverse effects. Clinical, radiological, and microbiological data on treatment response and overall outcomes after ALIS initiation were recorded for each patient. Results: By the end of 2023, 14 out of 17 patients had either successfully completed or were continuing their ALIS therapy. At 6 months, 85.7% (12\/14) showed clinical, microbiological, and radiological improvement. However, 25% (3\/12) of treated patients, primarily those with monomicrobial or combined M. abscessus lung disease, experienced disease relapse after therapy completion. The most frequent adverse effects related to ALIS were mild and localized to the respiratory tract, with only one patient discontinuing therapy due to hypersensitivity pneumonitis. Conclusions: Adding ALIS to standard regimens was effective and safe in a small group of Greek patients with refractory or recurrent NTM lung disease, particularly those who had discontinued intravenous aminoglycosides due to significant adverse effects, with notable responses observed in MAC lung disease. Further research is needed to validate these findings in clinical practice and to investigate ALIS\u2019s role in NTM lung disease caused by other species.<\/jats:p>","DOI":"10.3390\/medicina60101620","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T06:45:52Z","timestamp":1727937952000},"page":"1620","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Amikacin Liposomal Inhalation Suspension for Non-Tuberculous Mycobacteria Lung Infection: A Greek Observational Study"],"prefix":"10.3390","volume":"60","author":[{"given":"Angeliki A.","family":"Loukeri","sequence":"first","affiliation":[{"name":"Department of Mycobacterial Diseases, \u201cSotiria\u201d Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evgenia","family":"Papathanassiou","sequence":"additional","affiliation":[{"name":"Department of Mycobacterial Diseases, \u201cSotiria\u201d Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Kavvada","sequence":"additional","affiliation":[{"name":"Department of Mycobacterial Diseases, \u201cSotiria\u201d Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos F.","family":"Kampolis","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, \u201cHippokration\u201d General Hospital of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8846-519X","authenticated-orcid":false,"given":"Ioannis","family":"Pantazopoulos","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Mezourlo, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charalambos","family":"Moschos","sequence":"additional","affiliation":[{"name":"Department of Mycobacterial Diseases, \u201cSotiria\u201d Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5060-2910","authenticated-orcid":false,"given":"Apostolos","family":"Papavasileiou","sequence":"additional","affiliation":[{"name":"Department of Mycobacterial Diseases, \u201cSotiria\u201d Hospital, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1183\/09031936.00149212","article-title":"The geographic diversity of nontuberculous mycobacteria isolated from pulmonary samples: An NTM-NET collaborative study","volume":"42","author":"Hoefsloot","year":"2013","journal-title":"Eur. 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