In A Nutshell
During the early years of penicillin usage, it was difficult to extract enough of the drug from mold cultures to complete even one patient’s treatment, let alone enough to treat all the patients who needed the drug. Doctors discovered that up to 99 percent of injected penicillin was quickly excreted in urine in a form that was still active. So they began to recycle penicillin from urine in order to treat more patients. Fortunately, a moldy cantaloupe eventually alerted doctors to another type of mold that produced enormous amounts of the drug and the recycling stopped. But that’s caused a more modern problem. Excreted drugs now pollute our water supply, potentially affecting the health of fish and possibly even humans.
The Whole Bushel
Although the discovery of penicillin in 1928 gave doctors a potent weapon against bacterial infections, they still faced some serious challenges. During the early years of penicillin usage in the 1940s, it was difficult to extract enough of the drug from mold cultures to complete one patient’s treatment, and it was even more difficult to get enough to treat all the patients who needed the drug.
That’s why the first test case, Albert Alexander, died after contracting a bacterial infection in a cut on his face. The infection quickly spread to his eyes, scalp, lungs, and shoulder. Sulfa drugs were ineffective. So the doctors injected him with pure penicillin for five days. Alexander started to get better, but he needed more penicillin than the doctors had.
In 1942, Anne Miller was dying of sepsis after a miscarriage in Connecticut. Doctors tried treating her infection with penicillin, and she miraculously recovered. She was the first civilian patient to be cured with penicillin.
However, with World War II consuming a lot of the world’s resources, it was difficult to find the equipment and labor to manufacture enough of the medication from the mold cultures used at that time. That’s when doctors discovered that between 40 and 99 percent of injected penicillin was quickly excreted in urine in a form that was still active. By extracting the penicillin from one patient’s urine, they could recycle it to treat another patient. However, even with recycling, doctors were only able to treat 100 patients with penicillin in 1943.
There was also another problem. Penicillin was excreted so quickly and so completely that it didn’t stay in the patient’s body long enough to completely eradicate an infection. The drug could be recycled and injected back into the patient, but it wasn’t a perfect solution. Not only was the process time-consuming, some penicillin was lost when recycled. Eventually, an agent called probenicid was added to penicillin to slow its excretion from the human body. Greater manufacturing capacity also helped in later years.
However, one of the most beneficial discoveries came from a lab assistant returning from the market one day with a moldy cantaloupe. That mold produced 200 times more penicillin than the initial type of mold used to extract the drug. By the end of World War II, US drug companies were producing enough penicillin to make recycling unnecessary.
But that’s caused a more modern problem. Excreted drugs now pollute our water supply, potentially affecting the health of fish and possibly even humans. Many people also flush unused medicines down the drain or toilet, further contaminating our water. Hospitals and nursing homes have also done this frequently, although the Environmental Protection Agency has issued guidelines to discourage the practice. Two other sources of this type of water pollution come from drug manufacturing and farm animal waste that contains hormones and antibiotics.
Research has shown that estrogen and similar chemicals have created more female and intersex fish than normal in polluted waters. Intersex fish have both male and female traits. Some fish also behave differently after absorbing high amounts of drugs from their water. Mood-altering drugs like oxazepam can cause fish to eat more quickly, become less afraid of the unknown, and act anti-social.
Show Me The Proof
Featured photo via Wikipedia
NewsHour: The Real Story Behind Penicillin
Discover Magazine: The Magic Arrow: Penicillin & the Recurrin’ Urine
Harvard Medical School: Drugs in the water
Smithsonian: Flushing Your Anti-Anxiety Pills Down the Toilet Could Affect the Behavior of Wild Fish