Not long after Alexander Fleming recognized its laboratory effect on plates of beef broth, penicillin cured the ophthalmia neonatorum of several infants and the pneumococcal conjunctival contamination of a patient with a corneal laceration and intraocular foreign body. This was the first documented clinical success of penicillin. But the hospital notes of 1930-31 that described these cures are so sparse and incomplete that they show how little excitement was felt by the pathologist and ophthalmologist involved. The cases were neither presented at a formal conference nor submitted for publication.
No one at the time knew how to overcome the instability and variability of the crude extract of penicillin. Its success when applied directly to the bacteria on the surface of the eye was drowned out by its failure in other skin conditions and in systemic use when the effective dose was unknown. When sulfa drugs were introduced in 1935, their successes were more reliable and made clinicians feel that systemically-active antibacterial drugs, the real prize, could actually be realized. This change in attitude influenced the determined workers who eventually made penicillin the first effective injectable antibiotic.
Wainwright, M and Swan, HT: C.G. Paine and the earliest surviving clinical records of Penicillin Therapy. Medical History. 1986. 30:42-56
Submitted by Ron Fishman from the Cogan Ophthalmic History Society.