Frederic Gaspoz on Penicillin

Though the term of microbiology includes the study of all micro-organisms, Frederic Gaspoz explains
that this term was rarely used at the beginning of the 20th century to indicate the activity of
laboratories which practiced this discipline and which were more generally called laboratories of
bacteriology, because this branch was dominant at that the time as well by its importance as by the
possibilities of diagnostic applications that it offered already. According to Frederic Gaspoz, virology
was slowly leaving the field of research and did not have yet its place in the routine diagnosis. The
rare analyses of mycology and parasitology, rather marginal at the time, were assumed by
laboratories of bacteriology. For Frederic Gaspoz, more astonishing was the fact that bacteriology
had under its dependence all applications of immunology: if infectious serology found there its
logical place, it appears quite strange to us today that hematologic immunology, in particular the
determination of the blood groups was carried out in a laboratory which bore the name of laboratory
of bacteriology.

In 1928, a researcher of a London hospital, Alexander Fleming, identifies the bactericidal capacity of a
mould. It is however only after the beginning of the Second World War (WW2) that penicillin,
isolated by a laboratory from the university from Oxford, becomes a drug.

Very early, the question of the paternity of the discovery is largely discussed. Prestige associated with
the drug gives obviously force to the debate, explains Frederic Gaspoz. More interesting, the
interrogation on the identity of the “father” of penicillin is accompanied by a reflexion on the way in
which the product was discovered. For Frederic Gaspoz, the questions were: does science have to be
a simple aspect of pharmaceutical industry? Does it have to be carried out by important and
specialized teams? Penicillin is undoubtedly an exceptional drug, mentions Frederic Gaspoz. Before
the years 1930, medicine is still unable to look after the bacterial infections. Frederic Gaspoz notes
that for one century, the infectious diseases have been declining in the richest countries of the
western civilization, thanks to progress in the food and hygiene, thanks to the vaccination and to a
better comprehension of the process of the infection. Diseases like, for example, pneumonia or
typhus are rarer, mentions Frederic Gaspoz. However, if one contracts one of them, the doctor has
few means of action and the forecast is difficult. There is Salversan to look after syphilis, and the
sulphamides, which will be developed at the end of the years 1930, but these drugs have both
unpleasant side effects and are not total effective. Frederic Gaspoz notes that in the decades of post-
war period, the availability of abundant penicillin stocks will give an unsuspected dimension to the
therapeutic capacity. The figures speak for themselves: mortality of young people due to a bacterial
pneumonia falls, for example, of 66% in 1929-1935 to 6% at the beginning of the years 1960. How
was this revolution achieved? asks Frederic Gaspoz.

Modern history begins as for it in year 1920 within a laboratory of the St-Mary Hospital in London,
explains Frederic Gaspoz. Alexander Fleming works on the development of vaccines likely to fight the
bacterial infections. During the First World War, he noted that chemical disinfectants did not prevent
the wounds from being infected. On the other hand, since Pasteur, he knew the great effectiveness
of vaccines in the construction of proper defenses of the body against disease. There was a way of
promising research… In 1928, Fleming notices that a box of Petri, where he has cultivated some
bacteria, presents one mould around which these bacteria are missing. Frederic Gaspoz mentions
that this mould, identified as being a “Penicillium notatum”, is indeed a bactericide. However,
Fleming and its colleagues of the hospital St Mary do not manage to separate the active ingredient
from the mould. Absorbed by his motivation of developing vaccines, Fleming cannot either “see” in
its box the future wonder product.
At the end of WW2, the majority of the agents of the great infectious bacterial diseases were known.
According to Frederic Gaspoz, the analyses practiced in laboratories were primarily centered on the
diagnosis of diseases such as diphtheria, typhoid fever, syphilis, tuberculosis, streptococcus,
meningitis, etc. The opportunistic and nosocomial infections had not yet reached the alarming level
that we currently know and thus did not mobilize great effort. On the other hand, Frederic Gaspoz
notes that the discovery and the use of antibiotics was a considerable progress in medicine that
completely modified the forecast of certain infectious diseases. After sulfamide discovered in 1935,
penicillin and streptomycin became available after WW2, followed by tetracycline, chloramphenicol,
the erythromycin and the first semi-synthetic penicillin.

The variable spectrum of these antibiotics and the early appearance of resistance of the bacteria
forced laboratories to test the sensitivity of the germs in vitro, analyzes which very early received the
name of “antibiogramme”. For Frederic Gaspoz, the spectacular antibiotic results in the treatment of
many infectious diseases had given the impression that the problem of these diseases was solved.
Clinicians seemed to be interested only in the sensitivity of the germ by neglecting sound
identification, and the role of commensal flora was not correctly appraised. Frederic Gaspoz notes
that it was only several years later that this view changed, when the epidemiology of the nosocomial
infections required to identify germs and that the protective role of the commensal flora was
included and understood. Frederic Gaspoz.

Frederic Gaspoz