PENICILLIN 103 



salt of penicillin G and assays in the neighborhood of 1500 u/mg. The 

 value of the penicillin manufactured in the United States in 19-17 was esti- 

 mated at nearly 150 million dollars. 



The production of penicillin on a commercial scale has been reported by 

 Challinor and McNaughton (1943), Elder (1944), McKeen (1944), Calla- 

 ham (1944), and Coghill and Koch (1945). The reader is referred to these 

 papers for information regarding practices and problems of the manu- 

 facturing industry. 



Uses 



Penicillin is the drug of choice in the treatment of many types of bacterial 

 infection. It is not a cure-all, however, and it is of little or no value in the 

 treatment of many serious diseases. Generally speaking, its application 

 can be correlated with the identity and character of the pathogen. It is 

 particularly effective against the pyogenic cocci and the Gram-positive, 

 spore-forming bacilli, including the anaerobic forms belonging to the genus 

 Clostridium. Some of its major applications and limitations are presented 

 in the accompanying table. 



An enormous literature has developed on the clinical use and application 

 of penicihin since 1941. For information regarding its use in medicine the 

 reader is referred to works by Herrell (1945), Kolmer (1945), Fleming 

 (1946), and to the vast number of papers that have appeared during the 

 past five years in the Journal of the American Medical Association, the 

 Lancet, and other medical journals. 



Applications and Limitations of Penicillin'^ 



Penicillin is the most effective drug for Childbed fever 



the treatment of the following Localized infections elsewhere 

 conditions: Pneumococcic infections of the: 

 Staphylococcic infections, including: Meninges, pleura, endocardium, and 

 Carbuncles, boils, other abscesses lungs (especially sulfonamide re- 

 Acute and chronic osteomyelitis sistant pneumonia) 

 Meningitis, pneumonia and septicemia Gonococcic infections, particularly sul- 

 Sinus thrombosis fonamide resistant gonorrhea 

 Wound or burn infections All cases of anthrax 

 Clostridial infections, including: Meningococcic infections not responding 

 Gas gangrene to sulfonamides 

 Tetanus Bacterial endocarditis due to penicillin 

 Hemolytic streptococcic infections, in- sensitive organisms 

 eluding: Vincent's infection 

 Mastoiditis, peritonitis and septicemia Penicillin is effective in the treatment 

 Pneumonia, empyema and endocar- of the following diseases, but its 

 ditis abilit}^ to effect complete cures has 

 Childbed fever not been established : 

 Anaerobic streptococcic infections: Syphilis — especially in early stages 



2 Taken largely from a brochure with annotated bibliography, entitled "Peni- 

 cillin," published in 1945 by Merck and Co., B^ihway, N. J. 



