The history of penicillin traces how observations of antibiotic activity in the mould Penicillium led to the development of penicillins, a family of widely used antibiotics.
Ancient societies used moulds to treat infections, and many people observed the inhibition of bacterial growth by moulds. While working at St Mary's Hospital in London in 1928, Scottish physician Alexander Fleming was the first to show experimentally that a Penicillium mould secretes an antibacterial substance, which he named "penicillin". The mould was found to be a variant of Penicillium chrysogenum (now called Penicillium rubens), a contaminant of a bacterial culture in his laboratory. The work on penicillin at St Mary's ended in 1929.
In 1939, a team of scientists at the Sir William Dunn School of Pathology at the University of Oxford, led by Howard Florey, which included Edward Abraham, Ernst Chain, Mary Ethel Florey, Norman Heatley and Margaret Jennings, began researching penicillin. They developed a method for cultivating the mould and extracting, purifying and storing penicillin from it, together with an assay for measuring its purity. "Penicillin" now became the name of the active ingredient in the mould juice. They carried out experiments on animals to determine penicillin's safety and effectiveness before conducting clinical trials and field tests. They derived penicillin's chemical formula and determined how it works. The private sector and the United States Department of Agriculture located and produced new strains and developed mass production techniques. During the Second World War penicillin became an important part of the Allied war effort, saving thousands of lives. Alexander Fleming, Howard Florey and Ernst Chain shared the 1945 Nobel Prize in Physiology or Medicine for the discovery and development of penicillin.
After the end of the war in 1945, penicillin became widely available. Dorothy Hodgkin determined its chemical structure, one of the achievements for which she received the Nobel Prize in Chemistry in 1964. This led to the development of semisynthetic penicillins that were more potent and effective against a wider range of bacteria. The drug was synthesised in 1957, but cultivation of mould remains the primary means of production. It was discovered that adding penicillin to animal feed increased weight gain, improved feed-conversion efficiency, promoted more uniform growth and facilitated disease control. Agriculture became a major user of penicillin. Shortly after their discovery of penicillin, the Oxford team reported penicillin resistance in many bacteria. Research that aims to circumvent and understand the mechanisms of antibiotic resistance continues.
Early evidence
Many ancient cultures, including those in Australia, China, Egypt, Greece and India, independently discovered the useful properties of fungi and plants in treating infections. These treatments often worked because many organisms, including many species of mould, naturally produce antibiotics. However, ancient practitioners could not identify or isolate the active components in these organisms.
In 1895, Vincenzo Tiberio, an Italian physician at the University of Naples, published research on moulds initially found in a water well in Arzano; from his observations, he concluded that these moulds contained soluble substances having antibacterial action. A Pasteur Institute scientist, Costa Rican Clodomiro Picado Twight, similarly recorded the antibiotic effect of Penicillium in 1923. In these early stages of penicillin research, most species of Penicillium were non-specifically referred to as P. glaucum, so that it is impossible to know the exact species and that it was really penicillin that prevented bacterial growth.
André Gratia and Sara Dath at the Free University of Brussels studied the effects of bacterial samples on other bacteria. In 1924, they found that dead Staphylococcus aureus cultures were contaminated by a streptomycete. Upon further experimentation, they showed that an extract of the streptomycete could kill not only S. aureus, but also Pseudomonas aeruginosa, Mycobacterium tuberculosis and Escherichia coli (E. coli). Gratia called the antibacterial agent "mycolysate". The next year they found a killer mould that could inhibit B. anthracis. Reporting in , they identified the mould as Penicillium glaucum. These findings, however, received little attention as the antibacterial agent and its medical value were not fully understood, and Gratia's samples were lost.
Discovery of the properties of mould juice
While working at St Mary's Hospital, London in 1928, Alexander Fleming, a Scottish physician, was investigating the variation of growth in cultures of S. aureus, trying to replicate research from Trinity College Dublin. He spent the summer break with his family at his country home The Dhoon at Barton Mills, Suffolk. Before leaving his laboratory at the end of July, he inoculated several culture plates with S. aureus. He kept the plates aside on one corner of the table away from direct sunlight and to make space for his research student, Stuart Craddock, to work in his absence. He returned to his laboratory on 3 September. As he and Daniel Merlin Pryce, his former research student, examined the culture plates, they found one with an open lid and the culture contaminated with a blue-green mould. In the contaminated plate the bacteria around the mould did not grow, while those farther away grew normally, meaning that the mould killed the bacteria. Fleming photographed the culture and took a sample of the mould for identification.
Fleming resumed his vacation and returned to St Mary's that month. He collected the original mould and grew it in culture plates. After four days he found that the plates developed large colonies of the mould. He repeated the experiment with the same bacteria-killing results. He concluded that the mould was releasing a substance that was inhibiting bacterial growth. On testing against different bacteria, he found that the mould could kill only certain Gram-positive bacteria. Staphylococcus, Streptococcus and diphtheria bacillus (Corynebacterium diphtheriae) were easily killed, but there was no effect on typhoid bacterium (Salmonella typhimurium) and the bacterium once thought to cause influenza (Haemophilus influenzae). He prepared a culture method from which he could obtain the mould juice, which he called "penicillin" on 7 March 1929, "to avoid the repetition of the rather cumbersome phrase 'mould broth filtrate'."; Reprinted as In his Nobel lecture of 1945 he gave a further explanation, saying: I have been frequently asked why I invented the name "Penicillin". I simply followed perfectly orthodox lines and coined a word which explained that the substance penicillin was derived from a plant of the genus Penicillium just as many years ago the word "Digitalin" was invented for a substance derived from the plant Digitalis.
After structural comparison with different species of Penicillium, Fleming believed that his specimen was Penicillium chrysogenum, a species described by an American microbiologist Charles Thom in 1910. Charles John Patrick La Touche, an Irish botanist, had recently joined St Mary's as a mycologist, and he identified the specimen as Penicillium rubrum, the identification used by Fleming in his publication. In 1931, Thom re-examined different Penicillia, including that of Fleming's specimen, and he came to the conclusion that Fleming's specimen was P. notatum, a member of the P. chrysogenum series. From then on, Fleming's mould was synonymously referred to as P. notatum and P. chrysogenum. To resolve the confusion, the Seventeenth International Botanical Congress held in Vienna, Austria, in 2005 formally adopted P. chrysogenum as the name. Whole-genome sequence and phylogenetic analysis in 2011 revealed that Fleming's mould belongs to P. rubens, a species described by Belgian microbiologist Philibert Biourge in 1923.
The source of the fungal contamination in Fleming's experiment remained the subject of speculation for several decades. Fleming suggested in 1945 that the fungal spores came through the window facing Praed Street, but was disputed by his co-workers, who testified much later that Fleming's laboratory window was kept shut, and Fleming was unable to reach the window to open it. A consensus developed that the mould had come from La Touche's laboratory, a floor below Fleming's, and that spores had drifted in through the open doors.
To achieve the antibacterial effect on the staphylococci cultures that Fleming observed, the mould had to be producing sufficient amounts of penicillin no later than when the bacterial growth was beginning to form visible colonies, because penicillin is only effective on bacteria when they are reproducing. Fortuitously, the temperature in the laboratory during that August was optimum first for the growth of the mould, below 20 °C, and later in the month for the bacteria, when it reached 25 °C.
Fleming was a bacteriologist, not a chemist, so he left most of the chemical work to Craddock. In January 1929, Fleming recruited Frederick Ridley, a former research student of his with a background in biochemistry, to examine the chemical properties of the mould. Craddock and Ridley could not isolate penicillin, and before the experiments were over, both had left for other jobs.
Fleming reported his findings to the British Journal of Experimental Pathology on 10 May 1929, and they were published in the next month's issue, reprinted in but the article failed to attract much attention. Fleming was quite unsure of the medical application of his work and was more concerned with its application for bacterial isolation. The article also contained serious errors. Although Ridley and Craddock had demonstrated that penicillin was soluble in ether, acetone and alcohol as well as in water – information that would be critical to its isolation – Fleming erroneously claimed that it was soluble in alcohol and insoluble in ether and chloroform, which had not been tested. In fact, penicillin is soluble in ethanol, ether and chloroform. Further research was undertaken in the early 1930s by others including Harold Raistrick who confirmed the chemical instability of penicillin in 1932. While Fleming continued to send samples of the mould to researchers, the requests for samples tapered off.
Isolation
In 1939, at the Sir William Dunn School of Pathology at the University of Oxford, Ernst Boris Chain drew the attention of the professor in charge of the school, the Australian scientist Howard Florey, to Fleming's largely forgotten 1929 paper. They decided that the study of antibacterial substances produced by micro-organisms might be a fruitful avenue of research. Florey led an interdisciplinary research team that included Edward Abraham, Mary Ethel Florey, Arthur Duncan Gardner, Norman Heatley, Margaret Jennings, Jean Orr-Ewing and Gordon Sanders. Each member of the team tackled a particular aspect of the problem in their area of expertise, with simultaneous research along different lines building up a complete picture. This sort of collaboration was practically unknown in the United Kingdom at the time. Three sources were initially chosen for investigation: Bacillus subtilis, Trueperella pyogenes and penicillin. "[The possibility] that penicillin could have practical use in clinical medicine", Chain later recalled, "did not enter our minds when we started our work on penicillin."