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During World War I, Fleming worked at a special wound-research laboratory in Boulogne, France, headed by Wright.

There he began research that produced results more in keeping with Wrights thinking.

He was able to demonstrate that then commonly used chemical antiseptics like carbolic acid do not sterilize jagged wounds; rather, pus has its own antibacterial powers.

Using cells on a slide, he was able to show that chemical antiseptics in dilutions harmless to bacteria actually damage white blood corpuscles (leukocytes)the bodys first line of defense.

After World War I, Fleming continued to work on leukocytes and antisepsis. In 1921 he discovered a substance in nasal mucus that causes bacteria to disintegrate. Fleming and a colleague subsequently detected this substance, which he named lysozyme, in human blood serum, tears, saliva, milk, and a wide variety of other fluids.

In its natural state lysozyme seemed to be more effective against harmless airborne bacteria than against disease-causing bacteria. And attempts to concentrate it, thereby strengthening its antiseptic properties, proved unsuccessful.

Flemings

legendary discovery of penicillin occurred in 1928, while he was investigating staphylococcus, a common type of bacteria that causes boils and can also cause disastrous infections in patients with weakened immune systems.

Before Fleming left for a two-week vacation, a petri dish containing a staphylococcus culture was left on a lab bench and never placed in the incubator as intended. Somehow, in preparing the culture, a Penicillium mold spore had been accidentally introduced into the mediumperhaps coming in through a window, or more likely floating up a stairwell from the lab below where various molds were being cultured. The temperature conditions that prevailed during Flemings absence permitted both the bacteria and the mold spores to grow; had the incubator been used, only the bacteria could have grown. Flemings laboratory notebooks are sketchy, and his subsequent accounts of the discovery are contradictory. The evidence of the first culture, which he photographed, indicated that he observed lysis, the weakening and destruction of bacteriaas in his lysozyme studies.

But sometimes he described the key observation as an instance of inhibition or prevention of bacterial growth in areas affected by the mold juice, evidenced by a clear zone surrounding the mold.

Although these two effects occur under quite different conditions, Fleming probably forgot which observation came first, for in the months subsequent to the original observation he conducted many experiments while varying conditions systematically.

He discovered that the antibacterial substance was not produced by all molds, only by certain strains of Penicillium , namely, Penicillium notatum . Although he could not isolate it, he named the active substance penicillin. He studied methods of producing the impure product and determined its stability at different temperatures and over various lengths of time. He investigated its effect on many microbes, curiously omitting the familiar spirochete that causes syphilis (which Salvarsan controlled but did not eliminate). He tested its toxicity on a laboratory mouse and a rabbit.

Forever after, it has been a puzzle why he did not inject these or other laboratory animals with staphylococcus or other disease-causing bacteria before injecting them with the

fluid

containing penicillin.

Perhaps the explanation lay in his belief that cures come from within the body itself, rather than from an external agent. So he was not looking for a curative agent

but

rather focused on his new find as a topical antiseptic. In later years he claimed that the difficulties he had experienced in isolating and stabilizing penicillin, let alone the problems of producing sufficient quantities for clinical trials, had prevented him from realizing the full fruits of his research.

In fact, in the 1930s, little notice was taken by the scientific community of his paper published in the British Journal of Experimental Pathology (June 1929).

Those few scientists who sent for samples and tried to gain more understanding of the properties of penicillin did not or could not capitalize on Flemings discovery.

The information contained in this biography was last updated on December 5, 2017.

Study shows pharmacists knew more about penicillin allergy than MDs.

ARLINGTON HEIGHTS, IL (June 13, 2017 12:01 am ET) If you have gone through life avoiding certain antibiotics because you think youre allergic to penicillin, youd probably want to know if youre not actually allergic.

A new study shows many physicians who treat patients with penicillin allergy listed in their charts may not fully understand important facts about penicillin allergy. They may not be aware penicillin allergy can resolve over time and they dont fully understand the importance of allergy testing to make sure a penicillin allergy currently exists. The study in Annals of Allergy, Asthma and Immunology , the scientific publication of the American College of Allergy, Asthma and Immunology (ACAAI) examined 276 surveys completed by non-allergist physicians, physician assistants, nurse practitioners and pharmacists at Rochester Regional Health.

They found more than 80 percent of the general practitioners surveyed in their system knew a referral to an allergist for testing is appropriate for someone with a reported penicillin allergy. Despite that, the physicians had either never referred their patients to an allergist, or had only done so with one patient a year.

In addition, pharmacists surveyed in their system had a better overall understanding of penicillin allergy.

We were not surprised pharmacists

understood

the course of penicillin allergy better than other clinicians, given more extensive pharmacology education, says infectious diseases pharmacist Mary Staicu, PharmD, lead author of the study.

Of those surveyed, 78 percent of pharmacists knew penicillin allergy can resolve

over

time.

Only 55 percent of the remaining respondents (non-allergist physicians, physician assistants and nurse practitioners) did. The survey also showed a limited understanding among internists and general practitioners regarding the large numbers of people who report penicillin allergy but have never been tested. Most of the physicians surveyed had been in practice more than 10 years.

Between 10-20 percent of Americans believe they have a penicillin allergy.

But previous research has found only 10 percent of those people are truly penicillin allergic. In other words, 9 out of 10 people who

think

they have penicillin allergy are avoiding it for no reason.

Even in people with documented allergy to penicillin, only about 20 percent are still allergic ten years after

their

initial allergic reaction.

Our research found a poor understanding of penicillin allergy among non-allergists, says allergist Allison Ramsey, MD, study co-author and ACAAI member. This was not a surprising finding given the clinical experience of most allergists, but it does provide an excellent opportunity for education on the topic not just for patients, but for all health care professionals. People who are labeled penicillin allergic are often prescribed second-line antibiotics, which may have a higher risk of side effects and increased cost.

More than 90 percent of people labeled with a penicillin allergy can tolerate penicillin-based

antibiotics

, says Dr. Our survey

showed

only 30 percent of physician survey respondents knew that.

Its

important that doctors understand the importance of confirming penicillin allergy.

But its even more important that those who carry the label be educated and tested. An allergist can work with you to find out if you have a true drug allergy and determine what antibiotics are available for safe and effective treatment.

If youre not allergic, youll be able to safely use antibiotics that are often more effective, and less expensive.

An official website of the United States government. Federal government websites always use a .gov or .mil domain.

Before sharing sensitive information online, make sure youre on a .gov or .mil site by inspecting your browsers address (or location) bar. This site is also protected by an SSL (Secure Sockets Layer) certificate thats been signed by the U.S.



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