Who Discovered Penicillin And When Was It Discovered?
Perhaps nothing as important had been discovered that so impacted the life expectancy of the population as a whole. Except the toothbrush—that is, dental hygiene. If you can’t eat, you can’t live!iii
The story of an old mold
In 1928, Dr. Alexander Fleming, the bacteriologist at a Scotland hospital, returned from vacation to find his lab unkempt while he was gone. In fact, he noted that a mold had contaminated his culture dishes. Upon using a microscope to inspect the mold, he found the staphylococci culture he had was not growing well amid this mold. He wrote a paper published in the British Journal of Experimental Pathology, which was duly noted then ignored until a professor of pathology at Oxford came across iti.
But Who Invented Penicillin?
This professor, Dr. Howard Florey, in 1938—ten years after the mold incident—decided to apply the Fleming article’s information to a proper academic laboratory, with the result of selecting the most successful bacterial-killer species of this penicillin mold and then mutating it to increase its yield.
First Trial
By 1940, it was tried, albeit unsuccessfully, on a man with a strep and staph infection on his face. It was beginning to work, but ultimately there was not enough of the new drug to finish the eradicationii.
Penicillin First Medical Uses
Dental Hygiene and Penicillin Extended Life Expectancy
An aside: before dental hygiene, life expectancy was no longer than the life expectancy of one’s teeth. By the time someone was in his twenties, his teeth had rotted out of his head, he was shoved out the cave because he couldn’t eat, and the tiger got him. Well, perhaps not as colorful and melodramatic as that, but you get the point. Dental hygiene was an important milestone in the extension of life expectancy. After that, life expectancy didn’t really make leap forward until penicillin. That’s a long time.
Penicillin And The War
So in 1941, Florey flew to Peoria, Illinois, to pursue mass production, selecting out better penicillin species and tinkering with them via X-ray mutation. He and his team were successful, and by wartime it was being produced in volume to treat the most common cause of death in WWII—infection, not war injuries.
Penicillin And Civilians
In 1942—fourteen years after Fleming’s discovery—the first civilian patient, Anne Miller, was successfully treated for sepsis from a miscarriage. Needless to say, penicillin changed both the war and the world forever.
The Gram Stain Discovery
A crucial development that immensely revolutionized the screening for bacterial infections was in 1882, when Dr. Hans Christian Gram discovered his famous “stain” (Gram stain) which separated types of bacteria based on their morphology and characteristics. This made it possible to apply results to them systematically during the investigation of antibiotics lateriv.
Penicillin Resistant Bacteria
It is interesting that Dr. Fleming, acclaimed as the first discoverer of penicillin, also was the first to predict that overuse would lead to resistance. After his Nobel Prize in 1945, he said, “The thoughtless person playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection with the penicillin-resistant organism."v. True to this prediction, the cleverness of bacteria began an arms race with them to stay one step ahead for our side.
Historically, there has been evidence of traces of tetracycline in the bones of ancient people, obviously from their diet. Antibiotic properties of red soil in Jordan have been used to isolate antibiotic substances, from which the antibiotic, actinomycin, was isolated. Chinese and herbal remedies have contributed as well.
The Race To Cure Syphilis
Prior to the modern antibiotic era, syphilis was the impetus that jumpstarted the entire science of screening and synthesizing antibiotic substances. Dr. Paul Erlich, in 1904, began his search for the “magic bullet” that would selectively target only disease; 600 tries later, he found such a bullet for syphilis, up until then incurable. It was rough and had side effects—it was no penicillin!vi.
Why are bacteria so good at developing resistance?
Evolution is a crapshoot of trial and error. Most mutations are errors—deadly mistakes that don’t help a species and are incompatible with successful offspring. Bacteria are no exception. The mutations they develop, however, include resistances to antibiotics. Penicillin, with its molecular beta-lactam ring, is the classic example. Bacteria that mutated to make lactamase had the ability to break apart that crucial ring that made penicillin…well, penicillin.
Bacteria-1; penicillin-0.
Whereas mutations are rare in animals having only one, two, or even six babies at a time, the millions of offspring per hour in bacteria make mutations common. It’s just a numbers thing. The arms race mentioned above is very brisk and challenging with these types of fast-forward generations.
Antibiotic Types
In efforts to not re-invent the wheel, many natural sources of antibiotics were explored under the auspices of Pharmaceuticals. For example, Eli Lilly developed erythromycin from soil bacteria, and its next generation, clarithromycin, was developed by the Japanese Taisho Pharmaceutical; azithromycin (Zithromax and the Z-Pak) followed.
Antibiotic Medication List
There have been many classes of antibiotic developed over the years, including
- Sulfurs (currently in Bactrim, Septra, etc.)
- Beta-lactams (penicillins, including the next generation ones, ampicillin and amoxicillin—2nd generation, carbenicillin and ticarcillin—3rd generation, and piperacillin—4th generation
- Aminoglycosides (streptomycin, including later generations, gentamycin and tobramycin)
- Macrolides (erythromycin, including later generation ones, azithromycin and clarithromycin)
- Cephalosporins (Ancef, Keflin, Keflex, Duricef), and later generations, Ceftin, Cefzil, and Mefoxin—2nd, Cefobid and Rocephin—3rd, and beyond.
- Nitrofurans (Macrodantin)
- Tetracyclines (including later generation ones, such as Vibramycin)
- Rifampins
- Glycopeptieds (vancomycin)
- Quinolones (Ciprofloxacin/Cipro, Levaquin, NegGram)
- Many others
Myths and facts about antibiotics
Can you drink alcohol?
Yes you can. But alcoholic beverages are what are called diuretics, in that they make you urinate more, which is why you’re so thirsty after a bender the night before. The problem is that with more urination, you clear the antibiotic out of your bloodstream faster than predicted, meaning you might not be maintaining a consistent enough level of drug to fight your infection. The answer might seem to you to just take extra antibiotic, but since there are no formulas for how much extra you should take to make up for the drug clearance, the smartest thing and safest thing is to just not consume alcohol during treatment.
An added note: the antibiotic metronidazole (Flagyl) mixes very badly with alcohol. The reaction is similar to that of Antabuse, a medicine for alcoholism that makes alcohol consumption cause severe illness as a very strong negative reinforcement. Again, as a general rule, the smartest thing and safest thing is to just not consume alcohol during treatment.
Will any antibiotic help an infection?
No. Some bacteria are sensitive to only some classes of antibiotics, and some bacteria have developed resistance to some antibiotics within a class. Today’s medicine relies on something called the “culture and sensitivity” study. With this technique, a swab of the actual infecting bacteria is grown (the culture) in the lab and then each of the samples is tested for a single antibiotic (sensitivity). Today’s physician or nurse practitioner will get a report that identifies what the bacterium is and what antibiotics it is sensitive or resistant to. Administering an antibiotic before that is just a guess. And throwing several at an illness to “cover” for the possibilities is called “shotgun medicine.” Shotgun medicine is incorrect and not evidence-based, but sometimes it is necessary to prevent a rapidly progressing, life-threatening infection before the results of the culture and sensitivity come back, which can take several days.
Antibiotics, with rare exceptions, will not impact viruses, so treating a cold or flu with them is a waste of time, money, and fraught with helping bacteria in your body—minding their own business—develop resistance.
The choice of antibiotics begins with the Gram stain. Gram-Negative bacteria (red stained) and Gram-Positive ones (violet stained) are sensitive to different classes of bacteria.
What if I’m allergic to penicillin?
There are alternatives. However, if you’re allergic to one type of antibiotic in the class, you’d best stay away from the whole class itself. With so many classes available and new ones in development, you can still defeat an infection with an alternative.
You can display signs and symptoms of an allergy even after you’ve finished the antibiotics, so if you develop a rash a week after finishing your treatment, you should consider calling yourself “allergic” to that antibiotic.
Dermatologists can “desensitize” you to an antibiotic to which you’re allergic, but this is only necessary if your life depends on it.
How fast will an antibiotic work?
This depends on whether it is bacteriocidal (kills bacteria outright) or bacteriostatic (prevents new bacteria). Bacteriocidal works fast; bacteriostatic won’t show a response for 24 hours or so until the present survivors start dying off.
Fasting or full stomach?
Again, it depends. Some need an empty stomach to get absorbed without being wasted by sticking to food that will carry it away. Others need to hitch a ride on the process that absorbs the nutrients from food.
If I throw up, is that an allergy?
No. That’s a side effect. Nausea, diarrhea, and funny tastes in your mouth are not allergies. A true allergy will have a rash, itching, or even trouble breathing (seek help immediately).
What are the important resistant bacterial infections currently worrying the medical world?
The so-called “super-bugs,” such as Methicillin-resistant Staph Aureus (MRSA), were once in institutional, crowded facilities like nursing homes, but are now out and about. They are considered worrisome because they are resistant to later generation antibiotics. VRE (Vancomycin-resistant Enterocci), Clostridium Difficile (C-diff), CRE (Carbenicillin-resistant Enterobacteria), and other resistant bugs, such as those that cause gonorrhea, pneumonia, tuberculosis, salmonella, strep, and even yeast infections, are part of the list about which the CDC warnsvii.
Where will it all end?
It won’t. Ask the Martians who were in War of the Worlds. This is a beautiful world, and there are many competitors fighting for turf. It’s the ones we cannot see that pose as our biggest rivals, but as long as our technology outpaces evolution, we can stay on top of the food chain.
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Resources
i http://itech.dickinson.edu/chemistry/?p=107
ii http://www.pbs.org/newshour/rundown/the-real-story-behind-the-worlds-first-antibiotic/
iii https://crest.com/en-us/oral-care-topics/general-oral-hygiene/a-brief-history-of-oral-health-what-you-should-know
iv http://www.uphs.upenn.edu/bugdrug/antibiotic_manual/Gram1.htm
v http://www.businessinsider.com/alexander-fleming-predicted-post-antibiotic-era-70-years-ago-2015-7
vi (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109405/
vii https://www.cdc.gov/drugresistance/biggest_threats.html
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