Antimicrobial Medications

Paul Ehrlich (1854—1915), a German physician and bacteriologist, was born into a wealthy family. As the only son after many daughters, family and servants indulged his interests, even though his large collection of frogs and snakes occasionally entered the laundry room. As an adult, he was rarely without a good cigar and habitually scribbled notes on his shirt cuffs. After receiving a degree in medicine in 1878, he became intrigued with the way various types of body cells differ in their ability to take up dyes and other substances. When he observed that certain dyes stain bacterial cells but not animal cells, indicating that the two cell types are somehow fundamentally different, it occurred to him that it might be possible to find a dye or chemical that selectively harms bacteria without affecting human cells.

Ehrlich began a systematic search attempting to find a "magic bullet," a term he used to describe a drug that would kill a microbial pathogen without harming the human host. He began by looking for a chemical that would cure the sexually transmitted disease syphilis, which is caused by the bacterium Treponema pallidum. Much of the mental illness during this time resulted from tertiary syphilis, a late stage of the disease. Ehrlich knew that an arsenic compound had shown some success in treating a protozoan disease of animals, and so he and his colleagues began tediously synthesizing hundreds of different arsenic compounds in search for a cure for syphilis. In 1910, the 606th compound tested, arsphenamine, proved to be highly effective in treating the disease in laboratory animals. Although the drug itself was potentially lethal for patients, it did cure infections that were previously considered hopeless. The drug was given the name Salvarsan, a term derived from the words salvation and arsenic. The use of Salvarsan to cure syphilis proved that chemicals could selectively kill pathogens without permanently harming the human host.

—A Glimpse of History

THINK BACK TO THE LAST TIME THAT YOU WERE prescribed an antimicrobial medication. Could you have recovered from the infection without the drug? The prognosis for people with common diseases such as bacterial pneumonia and severe staphylococcal infection was grim before the discovery and widespread availability of penicillin in the 1940s. Physicians were able to identify the cause of the disease, but they were generally unable to recommend treatments other than bed rest.

A few of the many important antimicrobial medications

Today, however, antimicrobials are routinely prescribed, and the simple cure they provide for so many infectious diseases is often taken for granted. Unfortunately, the misuse of these life-saving medications, coupled with bacteria's amazing ability to adapt, has led to an increase in the number of drug-resistant organisms. Some people even speculate that we are in danger of seeing an end to the era of antimicrobial medications. In response, scientists are scrambling to develop new drugs.

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