Data from: Resource limitation prevents the emergence of drug resistance by intensifying within-host competition

Slowing the evolution of antimicrobial resistance is essential if we are
to continue to successfully treat infectious diseases. Whether a
drug-resistant mutant grows to high densities, and so sickens the patient
and spreads to new hosts, is determined by the competitive interactions it
has with drug-susceptible pathogens within the host. Competitive
interactions thus represent a good target for resistance management
strategies. Using an in vivo model of malaria infection, we show that
limiting a resource that is disproportionately required by resistant
parasites retards the evolution of drug resistance by intensifying
competitive interactions between susceptible and resistant parasites.
Resource limitation prevented resistance emergence regardless of whether
resistant mutants arose de novo or were experimentally added before drug
treatment. Our work provides proof of principle that chemotherapy paired
with an “ecological” intervention can slow the evolution of resistance to
antimicrobial drugs, even when resistant pathogens are present at high
frequencies. It also suggests that a broad range of previously untapped
compounds could be used for treating infectious diseases.