The full name of this class is "The Impact of Science and Technology on Business and Industry." Surely one of the greatest successes in which business and science has worked hand in hand to benefit both themselves and humanity in general has been in the development of antibiotics.

The first fairly good antibiotic to be widely used was not penicillin. It was sulfanilamide (more broadly called "sulfa drugs"). This family of drug was discovered by G.J. P. Domagk (1895-1964), a biochemist looking for drugs effective against bacterial diseases. He found a red dye that had no antibacterial properties, but when chemically modified would kill bacteria. He tested the drug on his own daughter, who was near death with a strep infection; she recovered completely. He published his results in 1935, and by 1936 the drug began being used.

Sulfa drugs were a hit. For example, the French Foreign Legion at one point found itself battling an epidemic of meningitis among its solders stationed in Nigeria. About 11% of the soldiers treated with sulfa drugs died. However, when they ran out of sulfa, about 75% of the soldiers infected died!

In World War II, sulfa was used widely. Those of you with fathers or grandfathers who fought in this war were given sulfa packets and told to sprinkle the drug on any open wound. This actually helped a great deal; during World War I most of the soldiers had not died of bullets but instead of infections. Sulfa probably cut this number of deaths in half.

However, the real breakthrough in antibiotics came with the discovery of penicillin, discovered by the Scottish bacteriologist Alexander Fleming. One day while cleaning out his lab he found some bacterial cultures that had been spoiled by mold growing in them. Fleming could have just thrown them out, but instead he noticed something curious: the bacteria growing closest to the mold wasn’t doing very well. He took some of the mold and injected it into a rabbit to see if the mold would poison the rabbit as well as the bacteria, but the rabbit was fine. Fleming had thus discovered penicillin—at least technically.

The problem was actually producing a product that could be useful to people. The "mold juice" was interesting, but Fleming could not figure out how to make it into a useful, stable product that could be easily used or was concentrated enough to be useful. Worse, Britain was occupied with both the Great Depression and with World War II, so businesses were too preoccupied with the war effort to investigate. Also, many people thought sulfa worked well enough that there wasn’t a pressing need for the research.

Fleming’s work, published in 1929, just lay there. A couple of other British scientists worked on the project in the late 1930’s, but they couldn’t get it to work either. They were able to make just enough of the drug for a few human trials, thus showing how promising the drug could be. However, the drug was so precious that the unused drug had to be recovered from the patient’s urine for purification and reuse!

Eventually the British scientists, with the help of the Rockefeller Foundation, moved their lab to the U.S., to keep their labs from being bombed by the Germans. Then, in 1941, a couple of scientists from the Midwest attended a conference in the Northeast where they heard of the research. These scientists worked for a small chemical company in Peoria, Illinois, named Pfizer. The people at Pfizer, many of whom were shareholders in their company, decided that this new and untried "mold juice" was worth a gamble, so they ended up investing three years and millions of dollars to get their promising but difficult-to-produce drug to work. Pfizer also had to cut back on production of its own established products as they worked around the clock on their new drug process.

Eventually they found a new strain of mold from a local rotting cantaloupe(!) brought in by Mary Hunt, a lab technician. This more potent mold, when combined with new fermentation processes developed by Pfizer, produced enough of the drug to make it practical. Pfizer shared their knowledge with some 19 other pharmaceutical companies, but many of the competitors had trouble getting the process to work correctly. As a result, 90% of the penicillin the go ashore at the 1944 D-Day invasion of Normandy was made by Pfizer.

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From there, penicillin went on the become known as the first real "wonder drug," saving countless lives. By the end of the war the U.S. was producing enough penicillin to treat 7,000,000 patients a year, and the drug was used to treat pneumonia, blood poisoning, strep throat, scarlet fever, diphtheria, syphilis, gonorrhea, meningitis, tonsillitis, rheumatic fever, and many other diseases. Pfizer itself benefited handsomely from this, as well it should have—the company’s management and employees (many of whom were stockholders in the company)—took on a great deal of risk and worked very hard to turn an exotic medical curiosity into a useful commercial product that turned out to surpass anyone’s wildest dreams. Indeed, to this day Pfizer (no longer a small company!) remains a major player in drug research and development; it was the inventor of tetracycline in the late 1950’s.

Penicillin was a smash hit—it cured many people who a few years earlier would have died from their infections of staph, strep, and many forms of pneumonia. However, there were some things that it could not do. Some forms of pneumonia could not be treated, and it also did not work against tuberculosis. Also, some people (about 1%) are allergic to penicillin, and others become allergic to the drug after using it for a while.

As a result, researchers quickly began looking for other fungi and microorganisms producing chemicals toxic to bacteria, but not to humans. This search quickly paid off when they discovered the actinomycetes. These are organisms commonly found in soil. One of the first of this new family of antibiotics to be produced was streptomycin (1943). Streptomycin (NOT related to strep throat!!) could be used to treat diseases against which penicillin was not effective. These included tuberculosis, Salmonella infections (a common food "poisoning"), certain urinary tract infections, and certain types of pneumonia. Other commonly-used actinomycete antibiotics followed, including tetracycline, erythromycin, neomycin, and numerous others.

While most of these new antibiotics came from bacteria some, like penicillin, came from the molds and fungi. Penicillin itself has been chemically modified a number of times. The original form (penicillin-G) had to be taken by injection; other forms were developed (penicillin-V) which could be taken in pill form. Many other penicillin variants have been developed as well, called "semi-synthetic penicillins." These are used to treat diseases that have become resistant to the original form of the drug.

Another major antibiotic, cephalosporin, comes from a close relative of the Penicillium mold used to make penicillin. Cephalosporins come from a mold originally found in sewage; the antibiotic works much like penicillin, but fights an even broader range of diseases and causes fewer allergic reactions.

While antibiotics have cured countless people of disease, many people fear that the drugs are beginning to lose effectiveness. The reason is that after a while, disease-causing germs start to figure out how to become immune to the antibiotics that kill them. Fortunately, this usually takes a long time, and even if the germs become immune to one drug, they can still be killed by another one. There are some germs, however, that have figured out how to resist more than one antibiotic. Someday, we could see serious common diseases that know how to defeat all of the antibiotics that we know how to produce. This will be Very Bad.

However, humans themselves are largely at fault for this problem. There are several reasons for this:

1. Antibiotics in United States and some other countries are overprescribed. Doctors will give prescriptions for antibiotics to people with colds and other viral infections. While this can help a few people keep from developing secondary infections (like colds that turn into pneumonia), most of the time it doesn’t really do anything for the patient. However, it does help enemy bacteria in the area "see" the antibiotic and give it time to figure out how to become immune to it.
2. Many farm animals are routinely given antibiotics in their feed—not to cure disease, but instead simply to prevent disease. Again, this is a great way to allow disease-causing germs to get used to an antibiotic. Also, small amounts of the antibiotics routinely given to cattle may find their way into our food, again giving germs a jump-start on beating the antibiotics. Also, there could be as-yet-unknown side effects from people consuming these low levels of antibiotics over time.

Note, too, that overuse of antibiotics can be bad for the individual taking the drugs.

1. Overuse can lead to an allergic reaction in the patient, because the person’s body begins to mistake the antibiotic for a foreign poison. Not only are the symptoms of this (which can include chills, fever, hives, rashes, or even anaphylactic shock and death in a few extreme cases), the person can no longer take the drug. When penicillin first came out, it was prescribed so often that many people became allergic.
2. Overuse can mess up our digestive systems, because there are certain bacteria that naturally live in our bodies that help us. If we take lots of antibiotics, we can kill the good bacteria along with the bad.
3. Finally, some antibiotics can be poisonous if overused. They can cause kidney damage, liver damage, and other problems.

The point here is not to be scary or to suggest that antibiotics are bad, but rather to make students aware that antibiotics should be used wisely and carefully. Follow your doctor’s advice, but if you have a bad reaction, check with your doctor immediately. Also, when you doctor does give you antibiotics, you should generally follow through the entire course of treatment--do not get half way through the bottle, decide you are feeling better, and stop taking the medicine. This can lead to a relapse, and to more anti-biotic resistant infection the second time around. But remember: these are just general guidelines and NOT medical advice. If you are sick, or have any question regarding your health or the health of dependents or loved ones, talk to a qualified medical doctor or health professional.

"1900-1950: New Processes and Products." http://www.pfizer.com/history/1900-1950.htm The historical capsules about Pfizer and the development of penicillin on the Pfizer website.

John C. Brown, "What the Heck is Penicillin?" http://people.ku.edu/~jbrown/penicillin.html Written by a molecular biologist teaching at the University of Kansas, this page is both easy to understand and fact-filled. The author explains how penicillin works to kill bacteria and how some bacteria can resist the drug. He also goes into detail about the people involved in the discovery and development of the drug.