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penicillinSmall amounts of the antibiotic were first obtained from strains of the mold species P. notatum grown in fermentation bottles. During World War II need for the drug spurred development of better production methods; in the current method highly productive strains of Penicillium are grown in a cornsteep liquor medium in fermentation vats. The main form of penicillin produced by this method is benzylpenicillin, which, like all penicillins, is a derivative of 6-aminopenicillanic acid. Phenoxymethyl penicillin, which can be given orally because it is resistant to degradation by stomach acid, is produced by the species P. chrysogenum.
EffectivenessPenicillin is effective against many gram-positive bacteria (see Gram's stain), including those that cause syphilis, meningococcal meningitis, gas gangrene, pneumococcal pneumonia, and some staphylococcal and streptococcal infections. Most gram-negative bacteria are resistant to the antibiotic, but some, such as the bacteria that cause gonorrhea, are susceptible, and others are responsive to high penicillin concentrations or to only certain classes of penicillins. Tuberculosis bacteria, protozoans, viruses, and most fungi are not affected by penicillin. The class of penicillins that includes ampicillin and amoxicillin with clavulanate (Augmentin) is active against gram-positive and gram-negative bacteria such as Haemophilus influenzae and Escherichia coli. All penicillins act by interfering with synthesis of the cell wall.
Drug Resistance and SensitivityUse of penicillin is limited by the fact that, although it causes fewer side effects than many other antibiotics, it causes allergic sensitivity in many individuals, including skin reactions and allergic shock. In addition, many microorganisms have developed resistance to the penicillins, and serious hospital epidemics involving infants and surgical patients have been caused by penicillin-resistant staphylococci (see drug resistance). Some organisms are resistant because they produce an enzyme, penicillinase, that destroys the antibiotic. Synthetically produced penicillins such as methicillin and oxacillin have been developed that are not degraded by the penicillinase enzyme, but these new penicillins have no effect on bacteria that have developed resistance by other means, e.g., by altered cell wall structure. Other antibiotics, such as erythromycin, have become important in treating infections by microorganisms resistant to penicillin.
See E. Lax, The Mold in Dr. Florey's Coat: The Story of the Penicillin Miracle (2004).
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