Small is big: growing impact of small molecule mass spectrometry in infectious disease drug development

Small molecule analysis by mass spectrometry (MS) in drug discovery and development has historically focused on confirmation of synthesis products and on drug quantification in pharmacokinetic and pharmacodynamic studies. However, advances in sensitivity, throughput, and cost of mass spectrometers, alongside improvements in data analysis pipelines, have led to increasing contributions of small molecule MS across drug discovery and development stages. In this minireview, I will discuss these recent technical advances in the context of infectious disease drug discovery and development, highlighting applications to high throughput screening and hit identification, the discovery of novel mechanisms of action, personalized treatment and diagnostics, and fighting treatment failure.