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First Use of Penicillin
Submit responseTo the Editor,
I thank Drs. Ortiz, Waggoner, and Jackson for their comments on “The First Use of Penicillin in the United States (1-3)." Dr. Waggoner was correct and I had missed an earlier report by Dawson et al in the Journal of Clinical Investigation (4). They had used penicillin in the treatment of subacute bacterial endocarditis; the limited amounts available were too small to save any of them. Dr. Jackson quotes a morbidity and mortality weekly report in 1999 as stating, “The patient survived, married, and raised a family." The patient had been a 33 year old already married to the Yale University athletic director. She had had a hysterectomy and bilateral saplingo-oophorectomy during her severe illness, without improvement. She had indeed met Dr. Fleming.
Perhaps my contribution should have been entitled “The First Successful Use of Penicillin in the United States” (5).
References
1. Ortiz. AG. Letter. Ann. Int. Med. 2009. 150:145
2. Waggoner, JJ. Letter. Ibid Pg.145-6
3. Jackson EA. Letter. Ibid Pg 146.
4. Dawson MH, Hobby GL, Meyer K, et al. J. Clin Invest 1941. (Abstract)20: 434.
5. Grossman, CM. The First use of Penicillin in the United States. Ann Intern Med. 2008. 149: 135-136.
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First use of Penicilin in Venezuela
Submit responseAfter reading the article published by Charles Grossman, I was interested in finding the first use of penicillin in my country. After a research on the internet, I found that the first reported us of penicillin in Venezuela was published in the "Gaceta Médica de Caracas" in 1944. This journal was the first of it´s type in Venezuea established in 1893 by Dr. Luis Razetti and the third in Latin America, followed by Gaceta Médica de México (1864) and the Revista Médica de Chile in 1872. It was a preliminary report by Dr. Gutierréz Alfaro JJ on the first case in Venezuela. It is remarkable to see that as early as 1944 we too were using penicillin in South America. Conflict of Interest:None declared
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The First Reported Use of Systemic Penicillin
Submit responseTo The Editor: I read with great interest the recent publication of Dr. Charles Grossman’s personal account of the “first dose of penicillin given in the United States” (1). The case involved the successful use of systemic penicillin to treat a young woman with & #946;-hemolytic streptococcal sepsis in March 1942. The young woman survived what likely would have been a fatal infection and lived to the age of 90. This article also details the actions of Dr. John Fulton, a physician who was himself sick in the hospital but nonetheless used his connections to obtain a supply of the necessary antibiotic. While Dr. Grossman provides a satisfying account of one patient’s treatment, this was not the first use of penicillin, administered systemically or otherwise, in the United States to treat an infected patient. In late 1940, Dr. Martin Henry Dawson, an associate professor of medicine at the College of Physicians and Surgeons of Columbia University,first used penicillin in the treatment of four patients with subacute bacterial endocarditis, though none of them survived. His team at Columbia used penicillin that had been obtained from cultures of Penicillium mold provided by Ernst Chain in England and Roger Reid in the United States (2). Their results were reported at the annual meeting of the American Society for Clinical Investigation in 1941 and published in abstract form later that year. Their presentation made only “brief mention… of the use of penicillin in human infections” (3). Dawson discussed the cases of endocarditis in a 1941 New York Times article entitled “’Giant’ Germicide Yielded by Mold,” with the subtitle “Tried on Human Beings.” In the article, Dr. Dawson explained that, as in many early cases, “sufficient material was not available for adequate therapy”(4). The United States produced the first case reports of systemic penicillin employed in an effort to cure infected patients, dating back over a year before the treatment of the patient reported by Dr. Grossman (1). These patients received treatment at a time when supplies of the antibiotic were limited and the purity could not be guaranteed. Despite these shortcomings, the initial responses to treatment were positive even if the final outcome was not. Though their stories are not as gratifying as a young woman cured of a deadly infection, it is important to properly recognize the first patients treated with penicillin for the contributions they made. References: 1. Grossman CM. The first use of penicillin in the United States. Annals of Internal Medicine 2008; 149: 135-6. 2. Parascandola J. The introduction of antibiotics into therapeutics. In: Leavitt JW and Numbers RL, eds. Sickness and Health in America, third edition. Madison, WI: The University of Wisconsin Press, 1997: 102-112. 3. Dawson MH, Hobby GL, Meyer K, and Chaffee E. Penicillin as a chemotherapeutic agent. Journal Clin Investigation 1941; 20: 434. 4. Laurence WL. ’Giant’ germicide yielded by mold. NY Times, May 6, 1941, p. 23. Conflict of Interest:None declared
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Death of the First Person to Receive Penicillin in the United States
Submit responseThank you for this very thorough and interesting account of the first use of penicillin in the United States. While reading this I was reminded of a very short description of this event published in Morbidity and Mortality Weekly Reports in July 1999, one month after the death of the patient described by Dr. Grossman. The MMWR account of this event contained the following information not included in Dr. Grossman's written report and accompanying interview that might be of interest to readers: ".....She survived to marry, raise a family, and meet Sir Alexander Fleming, the scientist who discovered penicillin."
1. Anon. The first American civilian saved by penicillin. MMWR. 1999;48:625.
Conflict of Interest:
None declared