The Development of Medicine through the History of Antibiotics
- Sophia Franklin-Ryan
- Aug 14
- 4 min read
Introduction
While media coverage into medicine development presents the industry as a single gleaming lab, with bubbling vials, shining lab coats and meticulous standards, the real process is significantly less glamorous than we might think. Antibiotics, one of the most significant treatments in human history, were developed slowly over centuries, from moldy bread to Fleming’s laboratory research and mass production. It involved guesswork, chance, careful research and significant funding to take antibiotics from an ancient home remedy to a widely administered life-saver.
How Antibiotics Work
Antibiotics essentially act as a hyper-specialised attack on bacteria. While the majority of bacteria in our body are extremely helpful, infection from other forms can be fatal. There are remarkably simple methods for eliminating bacteria, but the sort of treatment that entirely removes bacteria from the body frequently has a negative impact on non-negotiables like human body cells in general. While the most immediate and efficient way to kill bacteria might be ingesting a hand grenade, scientists tend to search for more localised treatments.
This is exactly what makes antibiotics so revolutionary; their ability to specialise. Bacteria and human cells have key differences, including the presence of a cell wall. While bacteria are protected by a net-like mesh of “peptidoglycan” in the cell wall, human and animal cells do not have one at all. This wall is formed by the linking of peptidoglycan chains, made possible by a certain enzyme, which is essential for the constant remodelling and maintenance of the bacterial life cycle.
Certain antibiotics including Penicillin make up the “beta-lactam family”, which prevent this enzyme from working in chain formation by binding to it. If the enzyme is unable to work on cross-linking, the cell wall eventually fails. Without protection from outside pressures, the cell, overwhelmed by the sudden water influx will burst and die, a process known as “osmotic lysis”. So although beta-lactam antibiotics may induce microscopic explosions, they are entirely localised and do not impact other cells. Although this class of antibiotics is only effective against bacteria with peptidoglycan walls, there are now many antibiotics which target other forms of bacteria and their unique biological compositions.
Ancient Antibiotics
For much of human history, a general lack of understanding made treating disease difficult. Bacterial infection was a common and deadly issue; any cut, badly prepared meal or air-borne bacteria could be fatal. While developing treatment is a difficult process now, in the ancient world without access to advanced equipment, or even an idea of how disease spread, it was even harder. The majority of effective medicinal treatments were established through trial and error. Independently from one another, major ancient societies dealt with bacterial infection in remarkably similar ways, relying on certain soils and moulding bread to treat wounds. These treatments might seem counter-intuitive, but some do in fact contain certain basic forms of antibiotics. While far less reliable than modern medication, these moulds were at least partially effective and were created with one of the few tools consistently available to humans throughout time, perseverance and guesswork.
The Magic Bullet
It wasn’t until 1904, when the rise of synthetic dyes led Paul Ehrlich to begin his systematic research into a cure for the venereal and highly deadly disease syphilis, that the history of antibiotics took its next major leap. Ehrlich became inspired when he realised that synthetic dyes could stain certain bacterial cells and not others. He concluded that it must be possible to develop a substance which could selectively destroy certain bacteria without harming other cells. This initial conclusion led to a five-year long journey of highly organised and consistent research on syphilis infected rabbits. Fortunately for Ehrlich (and his lab rabbits), in 1909, he and his team discovered arsphenamine, an effective treatment, later marketed under the name “Salvarsan”. The medicine was a success, later labelled “the magic bullet”, after its specialised, direct and effective elimination of the bacteria. Although Ehrlich’s meticulous approach and strong scientific rigour lead to the development of this first treatment, it was Fleming’s far more laidback approach to lab-keeping that revolutionised the history of antibiotics entirely.
Fleming’s Breakthrough
The delightful anecdote of Fleming's accidental discovery of Penicillin is well cited in the scientific world. After returning home from a trip in 1928, Fleming discovered that mould had accidentally contaminated a dish of Staphylococcus culture, and created bacteria free zones on the plate. He soon isolated the mold and grew it independently; even when diluted 800 times it was still effective at preventing the growth of Staphylococcus bacteria. Fleming named his discovery Penicillin, meaning tiny paintbrush, a reference to its soft and fluffy appearance, and published his results. However despite Fleming’s best attempts to create interest in the strain, it wasn’t until 12 years later, when a team at Oxford was able to purify the mold enough to lead to successful trials on mice that Penicillin’s potential was recognised fully.
Mass Production
Despite interest in Penicillin as a treatment, a major issue was an inability to generate enough of the mould to be administered effectively. The initial farming involved creating large amounts of mould broth, but even after inventing rudimentary fermentation vessels, only a few milligrams could be produced per week. In 1941 it was decided that Penicillin would be taken to the US in search for a more efficient fermentation process. An abundance of corn-steep liquor in one of the labs led to the discovery that when added to the mould broth it generated a much higher yield. The search was then extended to what mould naturally contained the highest quantity of Penicillin; eventually it was discovered that the cantaloupe could produce more than six times the amount generated by Fleming’s strain. Penicillin could now be produced and farmed at an efficient level; it only required sufficient funding to administer the treatment to the general population. Although Penicillin was shown to be remarkable, US pharmaceutical companies were wary of committing to widescale production. It wasn’t until the outbreak of the Second World War when demand for Penicillin skyrocketed that the medicine was produced en masse, saving countless lives.
However antibiotics weren't just invaluable throughout the war, they are still a widely prescribed treatment, making accidents and issues that were once fatal simply inconvenient. It is currently estimated that Penicillin alone has saved more than 200 to 500 million lives.
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