title: Drug resistance in eukaryotic microorganisms.
abstract: Eukaryotic microbial pathogens are major contributors to illness and death globally. Although much of their impact can be controlled by drug therapy as with prokaryotic microorganisms, the emergence of drug resistance has threatened these treatment efforts. Here, we discuss the challenges posed by eukaryotic microbial pathogens and how these are similar to, or differ from, the challenges of prokaryotic antibiotic resistance. The therapies used for several major eukaryotic microorganisms are then detailed, and the mechanisms that they have evolved to overcome these therapies are described. The rapid emergence of resistance and the restricted pipeline of new drug therapies pose considerable risks to global health and are particularly acute in the developing world. Nonetheless, we detail how the integration of new technology, biological understanding, epidemiology and evolutionary analysis can help sustain existing therapies, anticipate the emergence of resistance or optimize the deployment of new therapies.
authors: Dundee Drug Discovery Unit, Biological Chemistry and Drug Discovery, College of Life Sciences, University of Dundee, Dundee DD1 5EH, UK.
authors: Alan H
authors: 0000-0001-5134-0329
authors: AH
authors: Fairlamb
authors: Aberdeen Fungal Group, Wellcome Trust Strategic Award in Medical Mycology and Fungal Immunology, School of Medical Sciences, Institute of Medical Sciences, Foresterhill, University of Aberdeen, Aberdeen AB25 2ZD, UK.
authors: Neil A R
authors: NA
authors: Gow
authors: Centre for Immunity, Infection and Evolution, School of Biological Sciences, University of Edinburgh, Edinburgh EH9 3FL, UK.
authors: Keith R
authors: KR
authors: Matthews
authors: Wellcome Trust Centre for Molecular Parasitology, Institute of Infection, Immunity and Inflammation, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow G12 8TA, UK.
authors: Andrew P
authors: 0000-0001-8900-2982
authors: AP
authors: Waters
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D000981:Antiprotozoal Agents / Q000494:pharmacology*; D004351:Drug Resistance; D018432:Drug Resistance, Multiple; D004363:Drug Utilization; D005658:Fungi / Q000187:drug effects*; D014943:Global Health; D006801:Humans; D007891:Leishmania / Q000187:drug effects*; D009181:Mycoses / Q000188:drug therapy / Q000382:microbiology; D010961:Plasmodium / Q000187:drug effects*; D011528:Protozoan Infections / Q000188:drug therapy / Q000469:parasitology; D014345:Trypanosoma / Q000187:drug effects*
chemical_list: D000935:Antifungal Agents; D000981:Antiprotozoal Agents