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Aronson JK. When I use a word . . . Medicines regulation-penicillin. BMJ 2024; 384:q671. [PMID: 38490682 DOI: 10.1136/bmj.q671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Affiliation(s)
- Jeffrey K Aronson
- Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Follow Jeffrey on X (formerly Twitter): @JKAronson
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Lalchhandama K. History of penicillin. WIKIJOURNAL OF MEDICINE 2021. [DOI: 10.15347/wjm/2021.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The history of penicillin was shaped by the contributions of numerous scientists. The ultimate result was the discovery of the mould Penicillium's antibacterial activity and the subsequent development of penicillins, the most widely used antibiotics. Following an accidental discovery of the mould, later identified as Penicillium rubens, as the source of the antibacterial principle (1928) and the production of a pure compound (1942), penicillin became the first naturally derived antibiotic. There is anecdotal evidence of ancient societies using moulds to treat infections and of awareness that various moulds inhibited bacterial growth. However, it is not clear if Penicillium species were the species traditionally used or if the antimicrobial substances produced were penicillin. In 1928, Alexander Fleming was the first to discover the antibacterial substance secreted by the Penicillium mould and concentrate the active substance involved, giving it the name penicillin. His success in treating Harry Lambert's streptococcal meningitis, an infection until then fatal, proved to be a critical moment in the medical use of penicillin. Many later scientists were involved in the stabilisation and mass production of penicillin and in the search for more productive strains of Penicillium. Among the most important were Ernst Chain and Howard Florey, who shared with Fleming the 1945 Nobel Prize in Physiology or Medicine.
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Ukachukwu FU, Rafiq A, Snyder LAS. Challenges in treating ophthalmia neonatorum. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2021.1829475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Faith Uche Ukachukwu
- School of Life Sciences, Pharmacy, and Chemistry, Kingston University, Kingston upon Thames, UK
| | - Afshan Rafiq
- School of Life Sciences, Pharmacy, and Chemistry, Kingston University, Kingston upon Thames, UK
| | - Lori A. S. Snyder
- School of Life Sciences, Pharmacy, and Chemistry, Kingston University, Kingston upon Thames, UK
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Etymologia: Penicillin. Emerg Infect Dis 2019. [PMCID: PMC6302583 DOI: 10.3201/eid2501.et2501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Whittles LK, White PJ, Paul J, Didelot X. Epidemiological Trends of Antibiotic Resistant Gonorrhoea in the United Kingdom. Antibiotics (Basel) 2018; 7:antibiotics7030060. [PMID: 30011825 PMCID: PMC6165062 DOI: 10.3390/antibiotics7030060] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/06/2018] [Accepted: 07/11/2018] [Indexed: 11/16/2022] Open
Abstract
Gonorrhoea is one of the most common sexually-transmitted bacterial infections, globally and in the United Kingdom. The levels of antibiotic resistance in gonorrhoea reported in recent years represent a critical public health issue. From penicillins to cefixime, the gonococcus has become resistant to all antibiotics that have been previously used against it, in each case only a matter of years after introduction as a first-line therapy. After each instance of resistance emergence, the treatment recommendations have required revision, to the point that only a few antibiotics can reliably be prescribed to treat infected individuals. Most countries, including the UK, now recommend that gonorrhoea be treated with a dual therapy combining ceftriaxone and azithromycin. While this treatment is still currently effective for the vast majority of cases, there are concerning signs that this will not always remain the case, and there is no readily apparent alternative. Here, we review the use of antibiotics and epidemiological trends of antibiotic resistance in gonorrhoea from surveillance data over the past 15 years in the UK and describe how surveillance could be improved.
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Affiliation(s)
- Lilith K Whittles
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London W2 1PG, UK.
| | - Peter J White
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London W2 1PG, UK.
- MRC Centre for Outbreak Analysis and Modelling, School of Public Health, Imperial College London, London W2 1PG, UK.
- NIHR Health Protection Research Unit in Modelling Methodology, School of Public Health, Imperial College London, London W2 1PG, UK.
- Modelling and Economics Unit, National Infection Service, Public Health England, London NW9 5EQ, UK.
| | - John Paul
- Department of Microbiology, Public Health England Collaborative Centre, Royal Sussex County Hospital, Brighton BN2 5BE, UK.
- Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Falmer BN1 9PH, UK.
| | - Xavier Didelot
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London W2 1PG, UK.
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Escribá PV. Membrane-lipid therapy: A historical perspective of membrane-targeted therapies - From lipid bilayer structure to the pathophysiological regulation of cells. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2017; 1859:1493-1506. [PMID: 28577973 DOI: 10.1016/j.bbamem.2017.05.017] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Our current understanding of membrane lipid composition, structure and functions has led to the investigation of their role in cell signaling, both in healthy and pathological cells. As a consequence, therapies based on the regulation of membrane lipid composition and structure have been recently developed. This novel field, known as Membrane Lipid Therapy, is growing and evolving rapidly, providing treatments that are now in use or that are being studied for their application to oncological disorders, Alzheimer's disease, spinal cord injury, stroke, diabetes, obesity, and neuropathic pain. This field has arisen from relevant discoveries on the behavior of membranes in recent decades, and it paves the way to adopt new approaches in modern pharmacology and nutrition. This innovative area will promote further investigation into membranes and the development of new therapies with molecules that target the cell membrane. Due to the prominent roles of membranes in the cells' physiology and the paucity of therapeutic approaches based on the regulation of the lipids they contain, it is expected that membrane lipid therapy will provide new treatments for numerous pathologies. The first on-purpose rationally designed molecule in this field, minerval, is currently being tested in clinical trials and it is expected to enter the market around 2020. However, it seems feasible that during the next few decades other membrane regulators will also be marketed for the treatment of human pathologies. This article is part of a Special Issue entitled: Membrane Lipid Therapy: Drugs Targeting Biomembranes edited by Pablo V. Escribá.
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Affiliation(s)
- Pablo V Escribá
- Department of Biology, University of the Balearic Islands, E-07122 Palma de Mallorca, Spain.
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Escribá PV. WITHDRAWN: Membrane-lipid therapy: A historical perspective of membrane-targeted therapies-From lipid bilayer structure to the pathophysiological regulation of cells. BIOCHIMICA ET BIOPHYSICA ACTA. BIOMEMBRANES 2017:S0005-2736(17)30139-6. [PMID: 28476630 DOI: 10.1016/j.bbamem.2017.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/23/2017] [Accepted: 04/25/2017] [Indexed: 11/19/2022]
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.bbamem.2017.05.017. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Affiliation(s)
- Pablo V Escribá
- Department of Biology, University of the Balearic Islands, E-07122 Palma de Mallorca, Spain.
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Bodoev IN, Il’ina EN. Molecular mechanisms of formation of drug resistance in Neisseria gonorrhoeae: History and prospects. MOLECULAR GENETICS, MICROBIOLOGY AND VIROLOGY 2015. [DOI: 10.3103/s0891416815030027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future. Clin Microbiol Rev 2015; 27:587-613. [PMID: 24982323 DOI: 10.1128/cmr.00010-14] [Citation(s) in RCA: 773] [Impact Index Per Article: 85.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Neisseria gonorrhoeae is evolving into a superbug with resistance to previously and currently recommended antimicrobials for treatment of gonorrhea, which is a major public health concern globally. Given the global nature of gonorrhea, the high rate of usage of antimicrobials, suboptimal control and monitoring of antimicrobial resistance (AMR) and treatment failures, slow update of treatment guidelines in most geographical settings, and the extraordinary capacity of the gonococci to develop and retain AMR, it is likely that the global problem of gonococcal AMR will worsen in the foreseeable future and that the severe complications of gonorrhea will emerge as a silent epidemic. By understanding the evolution, emergence, and spread of AMR in N. gonorrhoeae, including its molecular and phenotypic mechanisms, resistance to antimicrobials used clinically can be anticipated, future methods for genetic testing for AMR might permit region-specific and tailor-made antimicrobial therapy, and the design of novel antimicrobials to circumvent the resistance problems can be undertaken more rationally. This review focuses on the history and evolution of gonorrhea treatment regimens and emerging resistance to them, on genetic and phenotypic determinants of gonococcal resistance to previously and currently recommended antimicrobials, including biological costs or benefits; and on crucial actions and future advances necessary to detect and treat resistant gonococcal strains and, ultimately, retain gonorrhea as a treatable infection.
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What if Fleming had not discovered penicillin? Saudi J Biol Sci 2014; 21:289-93. [PMID: 25183937 DOI: 10.1016/j.sjbs.2013.12.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 12/22/2013] [Accepted: 12/24/2013] [Indexed: 11/20/2022] Open
Abstract
What would have happened had Alexander Fleming not discovered penicillin in 1928? Perhaps the obvious answer is that, someone else would have discovered penicillin during 1930s and the Oxford group, would still have purified it sometime in the early 1940s. Here, however, in this counterfactual account of the penicillin story, it is argued that without Fleming, penicillin might still be undiscovered and the antibiotic age would never have dawned. As a result, many of the recent developments in medicine, such as organ transplantation, might have been delayed or, at best, made more hazardous. Penicillin might have come onto the scene a few years later but, had Fleming overlooked the discovery, it seems certain that penicillin would not have saved countless Allied lives, during and after D-Day. Instead of having enjoyed fifty and more years of the antibiotic age, it is argued here, that we would have had to rely upon highly developed sulphonamides, so-called "supasulfas", and other chemically-derived antibacterial drugs. Indeed, it might be the case that, even well into this new millennium, the antibiotic age has yet to dawn, and medicine is still waiting for someone to chance upon penicillin. Here we discuss what might have happened had Fleming not discovered penicillin and come to the conclusion that the medical armoury available today would have been far different and might have relied solely upon highly developed varieties of sulphonamides or similar, synthetic, non-antibiotic antibacterial agents.
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Mackey DA. Your time starts now - translation time lines for major ophthalmic discoveries. Med J Aust 2012; 196:672-4. [PMID: 22708753 DOI: 10.5694/mja11.11322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- David A Mackey
- Centre for Ophthalmology and Visual Science and Lions Eye Institute, University of Western Australia, Perth, WA.
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Bentley R. Different roads to discovery; Prontosil (hence sulfa drugs) and penicillin (hence β-lactams). J Ind Microbiol Biotechnol 2009; 36:775-86. [DOI: 10.1007/s10295-009-0553-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2009] [Accepted: 02/19/2009] [Indexed: 11/28/2022]
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Suárez C, Gudiol F. [Beta-lactam antibiotics]. Enferm Infecc Microbiol Clin 2009; 27:116-29. [PMID: 19254642 DOI: 10.1016/j.eimc.2008.12.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 12/16/2008] [Accepted: 12/17/2008] [Indexed: 10/20/2022]
Abstract
Beta-lactam drugs, whose mechanism of action is inhibition of the last stage of bacterial cell wall synthesis, are the largest family of antimicrobial agents and the most widely used in current clinical practice. These drugs have a slow, time-dependent bactericidal action, generally good distribution in the body, and low toxicity. Modifications of the original molecule have led to new compounds with a greater antimicrobial spectrum and activity; nonetheless, the use and efficacy of beta-lactams is limited in some clinical settings, owing to the increasing emergence of antimicrobial resistance. Despite this problem, penicillin remains the treatment of choice in a large number of infections, cephalosporins have a wide range of indications, carbapenems are used in nosocomially-acquired infection and infection caused by multiresistant microorganisms, and beta-lactam inhibitors restore the spectrum of activity of their companion penicillins (aminopenicillins, ureidopenicillins) when resistance is caused by beta lactamase production.
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Affiliation(s)
- Cristina Suárez
- Servicio de Enfermedades Infecciosas, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España.
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Rubin RP. A Brief History of Great Discoveries in Pharmacology: In Celebration of the Centennial Anniversary of the Founding of the American Society of Pharmacology and Experimental Therapeutics. Pharmacol Rev 2007; 59:289-359. [DOI: 10.1124/pr.107.70102] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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16
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Swan HT. Edinburgh medical students peculiarly described as 'occasional auditors'. JOURNAL OF MEDICAL BIOGRAPHY 2005; 13:207-17. [PMID: 16244714 DOI: 10.1177/096777200501300407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The phrase 'occasional auditor' appears to have been coined by a Royal Commission of 1826-32 to describe students who attended classes but did not intend to graduate. 'Occasional' meant 'infrequent', 'auditor' meant 'listener', and the Commission paid scant attention to these students. At the Edinburgh Medical School, however, such non-graduating students significantly outnumbered the graduates, and this can be shown to have been the case from as early as 1726 and to have continued until 1858, particular attention being paid here to the last two decades (i.e. 1839-58). There is no existing Edinburgh University list of 'occasional auditors', but a methodology of cross-referencing is described which makes it possible to identify the 'occasional auditors' by name. 'Occasional auditors' in the Faculty of Medicine can now be redefined as serious students who had assembled their own course of study in order to further their personal careers, and it is possible to show that very many of these careers were in medicine, largely in the emerging field of general practice.
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MESH Headings
- Curriculum/standards
- Education, Medical, Undergraduate/history
- Education, Medical, Undergraduate/standards
- Educational Measurement
- History, 18th Century
- History, 19th Century
- Humans
- Schools, Medical/history
- Scotland
- Students, Medical/classification
- Students, Medical/history
- Students, Medical/statistics & numerical data
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Bennett JW, Chung KT. Alexander Fleming and the discovery of penicillin. ADVANCES IN APPLIED MICROBIOLOGY 2002; 49:163-84. [PMID: 11757350 DOI: 10.1016/s0065-2164(01)49013-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- J W Bennett
- Department of Cell and Molecular Biology, Tulane University, New Orleans, Louisiana 70118, USA
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Wainwright M. Roger Reid's early contribution to the study of penicillin. JOURNAL OF MEDICAL BIOGRAPHY 1996; 4:14-17. [PMID: 11615342 DOI: 10.1177/096777209600400103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- M Wainwright
- Department of Molecular Biology and Biotechnology, University of Sheffield, UK
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Wainwright M. The mystery of the plate: Fleming's discovery and contribution to the early development of penicillin. JOURNAL OF MEDICAL BIOGRAPHY 1993; 1:59-65. [PMID: 11639213 DOI: 10.1177/096777209300100113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- M Wainwright
- Department of Molecular Biology and Biotechnology, University of Sheffield, UK
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Swan HT. The antibiotic record. Science 1990; 247:1387-8. [PMID: 2181661 DOI: 10.1126/science.247.4949.1387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Wainwright M. Besredka's "antivirus" in relation to Fleming's initial views on the nature of penicillin. MEDICAL HISTORY 1990; 34:79-85. [PMID: 2405221 PMCID: PMC1036002 DOI: 10.1017/s0025727300050286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- M Wainwright
- Department of Microbiology, University of Sheffield
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