By John D. Bullock, MD, MPH, MSc*§
Purpose: To review the history of penicillin (PCN) and to highlight the importance of ophthalmology/ophthalmologists
Methods: [1] Literature search; [2] Site visits
Results: Alexander Fleming's discovery of penicillin was one of the defining moments of the twentieth century and the contributions of ophthalmology/ophthalmologists to this endeavor were highly significant. An ophthalmologist advised Alexander Fleming to study medicine. Fleming discovered lysozyme's presence in tears and later recognized the same antibacterial effect (lysis) of PCN on Staphylococcus aureus. Fleming proved the non-irritancy of crude PCN by irrigating the human conjunctiva Q1Hx24 hours. The first extraction of PCN was by a future ophthalmologist. The first documented clinical successes of (crude) PCN were in cases of ophthalmia neonatorum. The first instance of a presumed PCN-resistant staphylococcal organism occurred in an ocular infection. Fleming's only clear-cut cure with crude PCN was in a case of pneumococcal conjunctivitis. The first PCN treatment of a post-traumatic infection was for an intraocular foreign body. The first use by Florey and Chain of injectable extracted PCN was for a case of endophthalmitis/orbital cellulitis. Six of ten cases in the original series of Florey and Chain, treated with extracted PCN, were ophthalmic patients. In the first spectacular life-saving cure, PCN was co-given by a future ophthalmologist.
Conclusion: Ophthalmology and ophthalmologists were instrumental in the inauguration of this new era of scientific therapeutic medicine.