Penicillin

Penicillin, 1946. Wellcome ImagesPenicillin became available for civilian use in British hospitals in August 1944. But prior to their use on general patients, Penicillin and the sulphonamide drugs had a major impact in Scottish hospitals.

During WWII, the Medical Research Council (MRC) specially selected the Glasgow Royal Infirmary as a centre for a nationwide investigation into the control of infection in burns, for which a new penicillin cream had been devised.

Penicillin trials conducted at the Royal Infirmary Edinburgh, where its value in the treatment of acute osteomyelitis was recognised, used a novel apparatus designed at the hospital to facilitate the administration of penicillin by drip (known as the ‘Eudrip’ apparatus).

The Eudrip was devised as a means of economising in the use of penicillin by regulating a slower rate of flow than existing apparatus. Soon after its introduction, the Eudrip was used in hospitals across Britain.

Initially, penicillin had to be administered by injection. Nurses recall that it was difficult to administer and patients recalled how painful administration by injection could be. Some patients were also hyper sensitive to it and experienced anaphylaxis. By 1946, penicillin was available in the form of a solution, cream, powder, snuff, lozenge and capsule. Companies began to market penicillin widely and the identification of an increasing number of antibiotics soon followed.

By 1958, resistance to a range of antibiotics was becoming a global health concern. Hospitals also became increasingly concerned about the growing costs associated with rapidly increasing levels of antibiotic prescribing practices.

Hospitals sought to tackle resistance and cost by developing policies restricting the use of some antibiotics and advocating the use of certain antibiotics in combination. Clinicians were under no obligation to adhere to these policies. Indeed, some saw it as a threat to their professional judgement.

Nonetheless, there is evidence to suggest that restricting the availability of some antibiotics in hospitals slowed the rate of resistance and was effective in reducing infection rates when used in combination with preventative strategies.

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