Since 1929, scientific investigators in England, and in the U.S. have conducted, experimental studies on a mould, penicillin, which promises unprecedented control over infection. Already this new drug has begun to save the lives and hasten the recovery of Army patients who might otherwise have died, been seriously crippled, or recovered only slowly.
Both clinical and laboratory experiments have demonstrated that penicillin is apparently non-toxic and highly effective in low concentrations against a wide variety of important pathogenic organisms, many of which resist the action of the sulfonamides. Unlike the sulfonamides, which operate by diminishing the rate of growth of bacteria, penicillin actually kills bacteria or stops their growth entirely. Its precise mechanism of action is not completely understood, but its discovery may make possible further important applications of a new principle. Among the bacteria which are not susceptible to penicillin are those which cause typhoid, paratyphoid, and dysentery.
Extensive clinical tests of the effectiveness of penicillin have been made on patients with serious infections of long duration and resistant even to sulfonamide therapy. They were suffering from intractable infections of soft parts, chronic ostiomyelitls, infected compound fractures, old Infected burns, empyema, and chronic gonorrhea. Carefully controlled observations on these cases have demonstrated the remarkable healing properties of penicillin, especially for cases for which little might otherwise be done. For example, the effectiveness of the sulfonamides against gonorrhea, spectacular as it is, does not extend to a significant portion of cases which at present become chronic and Incapacitated for active military duty. Penicillin returns such cases to duty within a few days.
Early problems of stability and the form of the product have been largely solved. Penicillin is now prepared as a sodium or calcium salt which is extremely stable in dry form. The chief problem of the moment is one of supply, although vigorous steps are being taken to make the drug available in larger quantities and less expensively. The present supply is sufficient only for experimental work, but expansion of productive facilities will soon make available to the Army enough of the drug to be employed clinically for more difficult cases. Because of the supply problem, penicillin is not likely to. be employed as a prophylactic against infection or in the cure of infections which respond readily to other types of therapy. Should success attend present efforts to synthesize the drug, the supply problem might be rapidly overcome.
In order to delineate more exactly the usefulness of this new drug, to determine its indications and contraindications, and to standardize the therapeutic procedures associated with its use, intensive studies are being conducted in specially equipped Army hospitals to which patients have been evacuated from overseas.