The accident of the discovery of penicillin (the first antibiotic) has been described as one of the luckiest that ever occurred in medicine. Since the discovery of penicillin other antibiotics, such as streptomycin, aureomycin, chloromycetin and terramycin, have been discovered. Each play their part in the service of doctors attacking infections due to bacteria in man.
Antibiotics are chemical substances produced by molds which kill or prevent the growth and multiplication of many micro organisms (germs) which infect and cause disease in man.
This warfare between molds and germs is going on in Nature all the time, in the soil, for instance, where they are in active competition, and we are only exploiting a weapon that Nature herself has already perfected.
Although germs can only be seen under a microscope, they require, like the largest mammals, some external source of food on which to live and grow, and antibiotics probably work by preventing the utilization of their simple food requirements.
The antibiotics are, before our very eyes, changing the course of human history. For centuries pneumonia, tuberculosis, typhoid fever and other bacterial infections have taken their toll of countless millions of lives. Now, most of these lives are saved.
Indeed, in over-populated countries, the widespread use of antibiotics is likely to have the unhappy effect of exchanging death from infection for a lingering death from starvation.
The grave responsibilities of parenthood, the watching over children gravely ill with mastoiditis, peritonitis, pneumonia, have been immeasurably lightened. A new era of surgery has been opened up, now that the danger of secondary infection has been lessened.
New fields to conquer in the surgery of the chest, heart and brain cheer the lives of thousands of patients and their relatives. To doctors treating tuberculosis the antibiotics have given new hope. Surgeons are now able, under streptomycin cover, to remove extensive areas of lung destroyed by tuberculous disease.
The effect of the antibiotics on many sociological patterns is already impressive. By prolonging the lives of the elderly the rate of “aging” of the population has been accelerated.
In consequence it is found that there are too few hospital beds for the aged sick, and that beds in hospitals for infectious diseases are no longer required for their traditional purpose. These administrative problems are having a profound effect on hospital planning.
Prevailing optimism has led people to refer to antibiotics as the “wonder drugs.” They are not, however, imbued with properties of magic, and it is well to know just what they can do and what they cannot do.
They are highly effective against some germs causing sore throat, most germs causing pneumonia and meningitis (cerebrospinal fever), most germs causing infections of the bowel and the urinary tract. Some bacteria are best attacked with penicillin; but against others the newer “broad spectrum” antibiotics (aureomycin and terramycin) are more effective.
The antibiotics are useless, however, against diseases caused by viruses.
A virus is a smaller thing than a bacterium and can not be seen under an ordinary microscope; but its size does not prevent it from being a serious trouble maker. The common cold, influenza, poliomyelitis, and epidemic jaundice are all virus diseases, and all wholly unaffected by antibiotics.
It is a regrettable fact that many people are falling into the habit of asking for and receiving antibiotics for coughs and colds due to virus infections. There is not a shred of scientific evidence, that they are of any greater value in prevention or treatment than the superstition of carrying a piece of potato in the trouser pocket.
It would indeed be a degrading thing if a magnificent life-saving scientific discovery were to degenerate to the level of mumbo jumbo and witchcraft, which is what is in danger of happening.
Experts have estimated that at least two-thirds of those capsules produced each year are misused and wasted on infections not requiring and not likely to respond to antibiotics. And many doctors are beginning to point to other and more fearful skeletons lurking in the cupboard.
One antibiotic (chloromycetin) caused a number of deaths due to severe anemia and bleeding. Even more alarming for the future is the fact that some germs soon become resistant to antibiotics.
If each patient kept his germs to himself there would be little cause for anxiety. But bacteria spread and are invasive, so that patients get infected with bacteria which, from the outset, are resistant to antibiotics.
The staphylococcus, the germ which led to the discovery of penicillin, is a notorious offender in this respect. A high proportion of the staphylococci moving through the community, have lost not only their sensitivity to penicillin, but often to other antibiotics as well.
Blood poisoning with the staphylococcus, which is likely to happen to any severely debilitated patient, is therefore often fatal. The increasing number of deaths of this nature occurring in hospitals throughout the world today is causing grave concern.
Uncritical use of antibiotics is therefore likely to cause the appearance of many strains of bacteria resistant to their action. Another result of the uncritical use of antibiotics is the fact that the true nature of a disease may be temporarily masked by a short course of these drugs.
Good doctoring has always been accurate scientific doctoring, and depends on the logical steps of observation of a patient’s symptoms-diagnosis-treatment. The shortcut of observation-treatment is bound, sooner or later, to lead to unhappiness and disaster.
Doctors are naturally anxious that the potent weapon placed in their hands should not be mishandled. In the fight of modern knowledge some simple rules regarding their use have been formulated:
- They do not have magical properties and cannot be expected to cure anything but bacterial infections.
- They are of no use in virus infections and therefore will not cure the bulk of minor respiratory sickness.
- They are specific in their action. To give all antibiotics together “just for luck” is as silly and wasteful as using every known commercial fertilizer on one’s rose garden.
NOTE: If these rules are followed the antibiotics will continue to be of service to man; if they are not it is likely that the objects of antibiotic treatment will be defeated.