Penicillin nucleusPenicillin was being mass-produced in earnest in 19443D-model of benzylpenicillin
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Bicillin

Penicillin refers to a group of β-lactam antibiotics used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms. The name "penicillin" can also be used in reference to a specific member of the penicillin group. Penicillins have the molecular formula R-C9H11N2O4S, where R is a variable side chain. more...

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History

Penicillin was originally isolated from the Penicillium chrysogenum (formerly Penicillium notatum) mould. The antibiotic effect was originally discovered by French medical student Ernest Duchesne studying Penicillium glaucum in 1896, but his discovery was ignored by the Institut Pasteur. Another Institut Pasteur scientist, Costa Rican Clodomiro Picado Twight was the first to record the antibiotic effect of Penicillium in 1923.

The serendipitous discovery was finally attributed to Scottish scientist Alexander Fleming in 1928, who noticed a halo of inhibition of bacterial growth around a contaminant blue-green mould on a Staphylococcus plate culture. Fleming concluded that the mould was releasing a substance that was inhibiting bacterial growth. He grew a pure culture of the mould and discovered that it was Penicillium notatum – he later named the bacterial inhibiting substance "penicillin" after the Penicillium notatum that released it. Fleming was convinced after conducting some more experiments that penicillin could not last long enough in the human body to kill pathogenic bacteria and stopped studying penicillin after 1931. It would prove to be the one of the discoveries that changed modern medicine. In 1939, Australian scientist Howard Walter Florey and a team of researchers at University of Oxford made significant progress in showing the in vivo bacteriacidal action of penicillin. On 1942-03-14 John Bumstead and Orvan Hess became the first in the world to successfully treat and save a patient using penicillin.

During World War II, penicillin made a major difference in the number of deaths and amputations caused by infected wounds amongst Allied forces. Availability was severely limited, however, by the difficulty of manufacturing large quantities of penicillin and by the rapid renal clearance of the drug necessitating frequent dosing. Penicillins are actively secreted and about 80% of a penicillin dose is cleared within three to four hours of administration. During those times it became common procedure to collect the urine from patients being treated so that the penicillin could be isolated and reused. (Silverthorn, 2004)

This was not a satisfactory solution, however, so researchers looked for a way to slow penicillin secretion. They hoped to find a molecule that could compete with penicillin for the organic acid transporter responsible for secretion such that the transporter would preferentially secrete the competitive inhibitor. The uricosuric agent probenecid proved to be suitable. When probenecid and penicillin are concomitantly administered, probenecid competitively inhibits the secretion of penicillin, increasing its concentration and prolonging its activity. The advent of mass-production techniques and semi-synthetic penicillins solved supply issues, and this use of probenecid declined. (Silverthorn, 2004) Probenecid is still clinically useful, however, for certain infections requiring particularly high concentrations of penicillins. (Rossi, 2004)

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Pinta
From Gale Encyclopedia of Medicine, 4/6/01 by Belinda M. Rowland

Definition

A bacterial infection of the skin which causes red to bluish-black colored spots.

Description

Pinta is a skin infection caused by the bacterium Treponema carateum, a relative of the bacterium which causes syphilis. The word "pinta" comes from the Spanish and means "painted." Pinta is also known as "azula" (blue), and "mal de pinto" (pinto sickness). It is one of several infections caused by different Treponema bacteria, which are called "endemic" or "non-venereal" treponematoses.

Pinta is primarily found in rural, poverty-stricken areas of northern South America, Mexico, and the Caribbean. The disease is usually acquired during childhood and is spread from one person to another by direct skin-to-skin contact. The bacteria enter the skin through a small cut, scratch, or other skin damage. Once inside the skin, the warmth and moisture allow the bacteria to multiply. The bacterial infection causes red, scaly lesions on the skin.

Causes & symptoms

Pinta is caused by an infection with the bacterium Treponema carateum. Persons at risk for pinta are those who live in rural, poverty-stricken, overcrowded regions of South America, Mexico, and the Caribbean. Symptoms of pinta occur within two to four weeks after exposure to the bacteria. The first sign of infection is a red, scaly, slowly enlarging bump on the skin. This is called the "primary lesion." The primary lesion usually appears at the site where the bacteria entered the skin. This is often on the arms, legs, or face. The smaller lesions which form around the primary lesion are called "satellite lesions." Lymph nodes located near the infected area will become enlarged, but are painless.

The second stage of pinta occurs between one and 12 months after the primary lesion stage. Many flat, red, scaly, itchy lesions called "pintids" occur either near the primary lesion, or scattered around the body. Pintid lesions progress through a range of color changes, from red to bluish-black. The skin of older lesions will become depigmented (loss of normal color).

Diagnosis

Pinta can be diagnosed by dermatologists (doctors who specialize in skin diseases) and infectious disease specialists. The appearance of the lesions helps in the diagnosis. A blood sample will be taken from the patient's arm to test for antibodies to Treponema carateum. A scraping of a lesion will be examined under the microscope to look for Treponema bacteria. The results of these tests should be available within one to two days.

Treatment

Pinta is treated with benzathine penicillin G (Bicillin), given as a single injection.

Prognosis

Treatment will result in a complete cure but will not undo any skin damage caused by the late stages of disease. Spread of pinta to the eyes can cause eyelid deformities.

Prevention

Good personal hygiene and general health may help prevent infections. In general, avoid physical contact with persons who have skin lesions.

Key Terms

Lesion
An abnormal change in skin due to disease.

Further Reading

For Your Information

    Other

  • Mayo Health Oasis. 1998. http://www.mayohealth.org (5 March 1998).

Gale Encyclopedia of Medicine. Gale Research, 1999.

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