Efficacy of liposome-encapsulated amikacin and free amikacin against Mycobacterium avium complex was evaluated in the beige mouse (C57BL/6J-bgl/bg') acute infection model. Approximately 107 viable M. avium complex serotype 1 cells for which the MIC of amikacin was 8 ,ug/mI were given intravenously. Treatment was started with encapsulated or free amikacin at approximately 110 or 40 mg/kg of body weight 7 or 14 days later. In the former experiment, treatment was given two or three times per week. In the latter experiment, treatment was given daily for 5 days. The animals were sacrificed 5 days after the last dose. Liver, spleen, and lung were homogenized, and viable cell counts were determined on 7H10 agar. An analysis of variance and subsequent Tukey HSD (honestly significant difference) tests indicated that both encapsulated and free amikacin significantly reduced viable cell counts in each of the organs compared with counts in the control group. Compared with free amikacin, encapsulated amikacin significantly reduced viable cell counts in the liver and spleen. Liposome encapsulation of an active agent appears to be a promising therapeutic approach to M. avium complex infection.Mycobacterium avium complex (MAC) is usually associated with chronic pulmonary disease in nonimmunocompromised patients (23) and disseminated infection in patients with acquired immunodeficiency syndrome (AIDS) (5,24). In patients with AIDS, the blood, spleen, liver, lymph nodes, bone marrow, and lung have been involved (10,12). In nonimmunocompromised patients, the intrinsic resistance of MAC to conventional chemotherapeutic agents is the primary problem with therapy (4). Patients with AIDS have the additional problem of a severely compromised immune system. There is currently no treatment regimen that is convincingly effective against MAC infection in patients with AIDS.Liposome encapsulation of a variety of antimicrobial agents has improved therapeutic efficacy, particularly in the treatment of disseminated, facultative, intracellular bacterial infections (19). Liposomes given intravenously concentrate in organs with sinusoidal capillaries containing reticuloendothelial cells, such as the liver, spleen, and bone marrow (14-16), which are frequently the sites of localization of disseminated bacterial infections. Liposomes are taken up by macrophages in vitro and in vivo, and liposome-encapsulated antimicrobial agents show greater killing of intracellular bacteria, including MAC, in macrophage cultures in vitro than do nonencapsulated antimicrobial agents (3,15,19).Various chemotherapeutic regimens for the treatment of MAC infection have been studied in normal (7, 13, 18) and beige (C57BL/6J-bgj/bgj) mice (5-8). Most drugs show little activity (7,13,18). Therapy with aminoglycosides may be effective but only at high doses for prolonged periods (8,13,18 the treatment of early MAC infection in beige mice compared with similar doses of the free drug. The purpose of the present study was to evaluate the efficacy of liposomeencapsulated amika...