Drug Resistance in Eukaryotic Microorganisms

Eukaryotic microbial pathogens are major contributors to illness and death
globally but much of their impact can be controlled by drug therapy. However, as with prokaryotic microbes, 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 microbes are then detailed and the mechanisms that they have evolved to overcome these described. The rapid emergence of resistance and
the restricted pipeline of new drug therapies pose significant risks to global
health and are particularly acute in the developing world. Nonetheless, we detail
how an integration of new technology, biological understanding, epidemiology
and evolutionary analysis can help sustain existing therapies, anticipate the
emergence of resistance or optimise the deployment of new therapies.