In Our Time, Penicillin

BBC Radio 4 - In Our Time, Penicillin

"He did do some trials on some of his colleagues at St Mary's. He grew the mold in liquid culture. He got one of his colleagues to eat some crud, some mold... Somebody who had a sore throat, it didn't really help them. Same person had some mold juice instilled in their nose when they had sinusitis...

The drug itself, penicillin, is not new. It's been around for millions, probably hundreds of millions of years in the soil. Because the molds protect themselves with it. And in fact you find resistance to penicillin in the most unlikely places... in corpses before Columbus in the New World... there's penicillin all around us...

In Asia, the idea of you could prevent the sex worker carrying gonorrhea. They would then give it to the soldier who would then be debilitated. Unfortunately what they did was they bred penicillin resistant gonorrhea which then disseminated...

Some of them do bizarre things. They change their own mutation rate. Their as in their own DNA. Produce hundreds or thousands of strange errors which normally wouldn't survive in nature but some of those manage to knock off the antibiotic so they can survive and the others die. And some even cut great sections out of their DNA, great chunks of DNA just thrown away, because that allows them to copy themselves more quickly. Now without penicillin, they would never survive. So that generally speaking, most bacteria are penicilin sensitive. But once you start using the antibiotic it's pretty certain that you're going to get resistance. We still have possibly one antibiotic which everything is more or less susceptible to, with very few exceptions. But now we realise the dangers. People are using these last ditch antibiotics much much more cautiously than they did before. And we're really almost at the end of that road of drug development, which is a real worry...

If you look at the number of companies over the last 30 years that are investing and researching in antibiotics, it's been dwindling. The number of companies involved in antibiotic research has dropped by 20-25% each decade for the last 3 decade. The financial drivers as you say are quite clear. For antibiotics you produce a medicine and I guess we're used to having antibiotics cheap. We're used to be able to pick up antibiotics for pence. You have a therapy which lasts for maybe a week or couple of weeks. Whereas the company is much more interested in having a drug which they can sell for a lifetime. It's a bit like... Starbucks. What would encourage Starbucks to make a coffee you would drink... for a week and would stop needing to drink Starbucks ever again in your life?...

drugs for hypertension, drugs for diabetes, companies invest a lot in that sort of area. So I think there need to be real financial drivers set up for the companies to encourage development...

MRSA... which spread like wildfire from a single mutation in Germany across Europe in just a few years. Now we know exactly what's going on there, and ironically enough it's begin to drop in frequency. Because of a new antibiotic? No. Because people now wash their hands... So maybe the simpler answers will be part of the solution"