The dramatic race to get enough penicillin
Chemists strive against time to provide gigantic doses needed by helpless victims of deadly endocarditis
by Robert D Potter, Science Editor
With the lives of thousands of human beings at stake, American chemists are engaged today in a strange and dramatic race.
The goal is to start mass production of penicillin, new potent germ-killing drug made from mold, in time to save the lives of many persons who cannot now obtain it. The best brains of American chemistry, plus $20,000,000, and the resources of 19 great chemical companies are in this race of mercy.
Helpless on the sidelines, mutely praying, are sufferers of some of man’s most deadly, baffling maladies.
No unfortunate group of sick persons stands more to gain by mass production of penicillin than those victims of bacterial endocarditis; dread, almost-always-fatal disease that attacks the heart of so many human sufferers.
In bacterial endocarditis, germs known as streptococcus viridans attack the valves of the heart. Before penicillin, doctors did what they could for this condition. Complete rest and a few remedies… there was little they could do for acute cases. But recent discoveries have established that penicillin can strike dramatically against this fatal ill.
Dr Leo Loewe and his associates at Brooklyn Jewish Hospital have treated 10 “hopeless” cases of bacterial endocarditis with penicillin. Eight of the patients are now germ-free of the streptococcus viridans.
Not a “cure” — but still a success
The Brooklyn doctors, in their cautious medical way, claim this is no “cure.” But for the eight patients, penicillin has been a miracle drug. The trouble with the treatment — and here is where the race with death comes in — is that huge quantities of penicillin must be used. And there just isn’t enough penicillin.
For a single case of subacute bacterial endocarditis, from 1,000,000 to 8,000,000 units of penicillin must be employed, says Dr Loewe. In contrast, doctors can conquer a case of pneumonia with only 100,000 units. Or they can whip a serious case of staphylococcus infections with only 30,000 to 50,000 penicillin units.
Doctors are thus faced with the dilemma of risking ten pneumonia patients for every case in which they use penicillin for bacterial endocarditis. Or they risk from 20 to 30 cases of osteomyelitis by the same decision.
Instead of putting the civilian coordinator of penicillin, Dr Chester Reefer of Boston, on the spot in making such decisions, the simplest way would be to increase production. Since two months is about the limit for patients suffering from acute bacterial endocarditis, can production be increased quickly enough to save victims who now have the disease?
Everything hinges on the next few months. Rush production is already under way. And according to an announcement in the authoritative American Medical Journal, enough penicillin for civilian, as well as military, needs should be available by June.
How penicillin is made
Three major methods are used for making penicillin.
The first, already being used, is to grow the mold of penicillin in small one-liter bottles where the mold grows on the surface of the liquid. The bottle method alone has produced penicillin up to the present time.
Scientists at Stanford University have discovered, however, that penicillin can be produced in tall towers in a manner already used in producing “quick” vinegar. In the quick process of making vinegar, a tall cylinder is filled with wood shavings. A culture of the bacteria that makes acetic acid is “planted” on the shavings. Cider or wine are then trickled down the tower. Vinegar comes off in quantity at the bottom of the column.
Professor C E Clifton of Stanford has adapted this technique for the production of penicillin. The shavings are moistened with a solution of 4% glucose (sugar) and 0.1% yeast extract. This food is planted with the spores of the penicillin mold. Nutrient solution for the mold is then trickled down the tower.
The mold digests the liquid. Out of the bottom of the cylinder comes a solution rich in penicillin.
But the biggest method, and the one expected to yield vast production in penicillin, is the vat method. Here the mold is grown in great tanks, up to 10,000 gallons in capacity. Government WPB contracts have been let to obtain large-scale prodution by the vat method. While this $20,000,000 production program is going on, independent research seeks still more production.
Great efforts are being made to find a strain of the penicillin mold which will give an even greater yield of the drug, or perhaps produce still some other chemical which will be as good or better. Intensive research is underway, but at the end of 1943, the original mold used by Prof Alexander Fleming in England in 1929 still was the best penicillin producer. This mold is called Penicillium notatum.
When mass production of penicillin is underway, the cost will drop greatly. Formerly, the price for treatment was about $20 for a million units. Already, the cost is down to $8 for a million units.
Synthetics a goal
The real drop will come when chemists synthesize the drug, and create it from chemicals in the laboratory as they now produce the sulfa drug. This is the ultimate goal. Using a mold to produce penicillin is merely stopgap, for it utilizes a most delicate form of plant life as an intermediate chemical factory.
There are rumors but no authentic announcement that the synthesis of penicillin is on the way. Stories are making the rounds that the structure of penicillin has already been determined. If true, this is a sure step on the path of man-made penicillin.
When the synthesis of penicillin is achieved it will probably make obsolete the $20,000,000 plant installations now being rushed.
Top photo: Dr Andrew Moyer, in his Peoria laboratory, where he discovered the process for mass-producing penicillin