Saturday, December 21, 2013

Wisdom Of The Week

Never in my wildest dreams, I thought someone in early 20tth century would have warned us about the overuse of antibiotics is leading to increasing bacterial resistance. But of all people, Alexander Fleming, the discoverer of penicillin, feared microbial resistance and discussed it in his Nobel Prize speech of 1945  (via Mark Bittman who thinks FDA is bull sitting again and we’re looking at an industry-friendly response to the public health emergency of diseases caused by antibiotic-resistant bacteria, resistance that is bred in industrially raised animals.). Full text of Alexander Fleming's Nobel lecture - here:

Their results were first published in 1940 in the midst of a great war when ordinary economics are in abeyance and when production can go on regard- less of cost. I had the opportunity this summer of seeing in America some of the large penicillin factories which have been erected at enormous cost and in which the mould was growing in large tanks aerated and violently agitated. To me it was of especial interest to see how a simple observation made in a hospital bacteriological laboratory in London had eventually developed into a large industry and how what everyone at one time thought was merely one of my toys had by purification become the nearest approach to the ideal substance for curing many of our common infections.

And we are not at the end of the penicillin story. Perhaps we are only just at the beginning. We are in a chemical age and penicillin may be changed by the chemists so that all its disadvantages may be removed and a newer and a better derivative may be produced.
Then the phenomenal success of penicillin has led to an intensive research into antibacterial products produced by moulds and other lowly members of the vegetable kingdom. Many substances have been found but unfortunately most of them have been toxic. There is one, however, streptomycin, which was found by Waksman in America which will certainly appear in practical therapeutics and there are many others yet to be investigated.

But I would like to sound one note of warning. Penicillin is to all intents and purposes non-poisonous so there is no need to worry about giving an overdose and poisoning the patient. There may be a danger, though, in underdosage. It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body.

The time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant. Here is a hypothetical illustration. Mr. X. has a sore throat. He buys some penicillin and gives himself, not enough to kill the streptococci but enough to educate them to resist penicillin. He then infects his wife. Mrs. X gets pneumonia and is treated with penicillin. As the streptococci are now resistant to penicillin the treatment fails. Mrs. X dies. Who is primarily responsible for Mrs. X’s death? Why Mr. X whose negligent use of penicillin changed the nature of the microbe. Moral: If you use penicillin, use enough.


And 68 years later, today we here in this country are feasting on meat laden with antibiotics three times day, everyday. Of-course most don't even think of the sufferings of these poor animals (yes, life they live is much worse than their death). To borrow John Gray's phrase - "Is this what we call progress?"

No comments: