PENICILLIN

Korero (AEWS), Volume 2, Issue 1, 17 January 1944, Page 24

PENICILLIN

Penicillin is a new anti-bacterial drug effective against the same disease germs as the sulfonamides and approximately as rapid in action. Clinical results with this drug have been described as startling, but the drug is not yet available either to the general public or to the medical profession, and, according to the American magazine, The New Republic, from which this article is reprinted, there is little hope of adequate supplies for some time to come. Penicillin (pronounced, incidentally, with a soft c and the accent on the third syllable) is so named because it is produced by the fungus, Penicillium notatum. The drug was originally discovered in 1929 by Professor Alexander Fleming in St. Mary’s Hospital in London. ' \ Dr. Fleming happened to observe that when a mixed growth of this particular mould and various species of germs were grown together on a culture-plate the bacterial-colonies kept at a safe distance

from the fungus. From this observation he deduced that the mould must exude some substance inimical to the wellbeing of bacteria.

By growing the fungus on a somewhat larger scale he demonstrated not only the truth of this inference, but that the substance concerned was far more potent than any bactericide previously uncovered. His difficulty, which finally proved so insuperable as to lead him to abandon his research, lay in the fact that he was unable to extract penicillin in anything like pure form. This catastrophic ending to a brilliant piece of research was eventually retrieved in 1940 by a group of scientists working at Oxford University under a grant from the Rockefeller Foundation. Labouring under such handicaps as only a state of war can impose, this group succeeded, despite all obstacles, in isolating penicillin in solid though still somewhat impure form.

This chemical triumph was rapidly overshadowed by the astonishing clinical success which came hard upon its heels. In the main, first experiments were confined to patients suffering from suppurative disease which had proved resistant to sulfonamides and which by all known standards might be deemed hopeless. Injection of penicillin into the veins of these patients not only proved entirely harmless, but brought about astonishing improvement in their clinical condition.

Unfortunately, although many of these previously hopeless cases rallied to the point at which recovery might have been expected, supplies of penicillin proved inadequte even for the cautious dosage which was being employed.

In the autumn of 1941 Professor Howard W. Florey, who had occupied a leading position in this penicillin research, visited the United States. As part of his itinerary he visited the Peoria Laboratory of the United States Department of Agriculture, where subsequent studies have revealed many of the growth characteristics of the mould and have gone a long way toward further purification of the active substance.

However, even more important was the fact that Florey’s visit succeeded in interesting potential manufacturers in the production of penicillin for clinical trial. Outstanding among these manufacturers has been Merck and Company, Inc., of Rahway, New Jersey, which has not only produced sizable quantities of the drug, but has greatly developed its method of production.

With the entry of the United States into war, supplies of penicillin for clinical trial came under Government control. Dr. Chester Keefer, acting under the aegis of the Committee on Medical Research, was appointed to supervise the distribution of the drug for medical investigation. Under his guiding hand extensive experimentation has been conducted, the details of which are still largely undisclosed. However, it is now obvious that penicillin is a discovery of as great importance as that of the sulfonamides.

In general, penicillin is effective against the same disease germs as are the sulfonamides and is approximately as rapid in action. It should be added that whereas the sulfonamides are at their best in the early invasive stages of disease, penicillin seems more or less indifferent to the stage to which the infective process has progressed.

Furthermore, while the action of the sulfonamides is neutralized by the presence of pus, the effect of penicillin seems undisturbed either by its presence or absence, and hence it can be used effectively in many cases, such as deep-lying bone abscess, in which the use of the sulfonamides would be futile.

Like the sulfonamides, penicillin can be applied locally to diseased tissue with the additional advantage that, unlike the sulfa-drugs, in cases of meningitis it can be injected with safety directly into the fluid surrounding the spinal cord. Used directly on ulcers, on infected fingers, in septic wounds penicillin has produced results which leave no doubt as to its superlative efficacy.

Moreover, from present indications it appears that penicillin will be effective against a wider variety of bacteria than the sulfonamides and will prove an effective agent in most varieties of sepsis, in pneumonia, gonorrhoea and certain forms of meningitis.

The bugbear that has now to be fought is underproduction. Army and navy hospitals are absorbing present supplies and could utilize many times the quantity they are now taking. With present methods of production, it seems unlikely that adequate supplies for civilian use will be available for months or possibly years. Synthesis of the drug seems at the present time remote, but there is hope to be found in the fact that manufacturers are engaged in a race against time and against one another in attaining this objective, the achievement of which would almost certainly bring the drug within the reach of the practising physician. ©