The person who will determine who gets what inhalational drug(s) . . .
will be the director of the diagnostic laboratory where antibiotic sensitivity discs from all the approved inhalational antibiotics . . . applied to a nutrient agar pour plate (with Pseudomonas aeruginosa isolate mixed in the agar before poring) . . . and has at least one zone of no growth (probably 5-7 mm larger than the disc)around one or more of the antibiotic discs. That director is going to write a report to the clinician in charge of the case that in order of sensitivity testing, inhalational antibiotic A is better than B, C, D or E, but that C and E also have clear zones that indicate bactericidal activity. That report will be reviewed by the clinician and in consultation with the patient, the inhalational antibiotic regimen will be determined.
There are so many strains of Pa that different antibiotics among A, B, C, D and E will be chosen for each case. So if Arikace gets approved, it will be among the inhalational antibiotics tested. WL put the emphasis on the once per day inhalation regimen and the residual accumulation in the macrophages of the lung. That is still the strongest case . . . medically speaking.
All this stock broker wanabe stuff is . . . . (add your own ending).