Latest news with #penicillin
The Independent
4 days ago
- Health
- The Independent
Churchill documents reveal D-Day landings boosted by import of ‘wonder drug' from America
Newly unearthed documents have revealed that the D-Day landings received a boost from the import of a "wonder drug" from America. Despite its discovery in London in 1928 by Sir Alexander Fleming, large-scale production of the antibiotic penicillin had struggled to take hold in Britain. Attempts to produce substantial quantities of medicine from the bacteria-killing mould had not been achieved by the start of the Second World War. Then prime minister Sir Winston Churchill became increasingly frustrated that Britain had not been able to produce enough penicillin in the preparations for the Normandy landings in 1944. Official papers released by the National Archive – containing handwritten notes by Sir Winston – highlight efforts to boost quantities of the antibiotic, with Britain eventually forced to import it from America. The documents were released ahead of the 81st anniversary of D-Day, the Allied invasion of Normandy on June 6, 1944. In one report on February 19, after the issue had been raised in the House of Commons, Sir Winston scrawled in red ink on a Ministry of Supply report noting the Americans were producing greater quantities: 'I am sorry we can't produce more.' On another paper, he complained: 'Your report on penicillin showing that we are only to get about one tenth of the expected output this year, is very disappointing.' Elsewhere in the same file he instructs: 'Let me have proposals for a more abundant supply from Great Britain.' With preparations for D-Day ramped up, efforts to deliver enough American-made penicillin for frontline military personnel soon became a matter of urgency. Decisions needed to be made on the quantities of antibiotic imported, how much to administer to individual patients, and how to get medical staff trained in time. Most British doctors did not know how to issue penicillin – until this point, doctors had nothing available to treat infections like pneumonia and many people died of blood poisoning after minor injuries because no drug existed that could cure them. Early in January 1944, Prof FR Fraser, the Ministry of Health's adviser on the organisation of wartime hospitals, wrote that 50,000-100,000 wounded could be expected from the Second Front. He proposed the Emergency Medical Services might need as many as five billion units of penicillin per month for this. Further documents show discussions on whether the antibiotic should be supplied as calcium or sodium salts, or in tablet form. Ultimately, it was agreed powdered calcium salts would be issued for superficial wounds and sodium salts for use in deep wounds. On May 24 1944, less than a fortnight before D-Day, Prof Fraser reported: 'Sufficient supplies of penicillin are now available for the treatment of battle casualties in EMS hospitals, but not for ordinary civilian patients.' Plans were made for casualties from the frontline in France to be brought back to coastal hospitals in Britain for treatment. A week before D-Day, on May 30 1944, hospitals were instructed to treat battlefield patients en route: 'In an endeavour to prevent the development of gas gangrene and sepsis in wounds the War Office have arranged for the treatment of selected cases by penicillin to be commenced as soon after injury as possible.' Injections of penicillin were to be given to them at intervals of not more than five hours and patients would be wearing a yellow label with the letters 'PEN'. The time and size of penicillin doses should be written on it, they were told. Dr Jessamy Carlson, modern records specialist at the National Archives, said: 'File MH 76/184 gives a glimpse into the extraordinary levels of preparation undertaken in advance of the D-Day landings. 'Only six weeks before, penicillin is just reaching our shores in quantities which will allow it to play a major role in improving the outcomes for service personnel wounded in action.' As Allied forces made inroads into Europe, restrictions on the use of penicillin for civilians began to relax, but only in special cases. In July 1944, Ronald Christie, professor of medicine, wrote to Prof Fraser to tell him: 'The War Office approves of American penicillin being used for medical conditions in service patients and for air raid casualties among civilians.' On the home front, demand for the new 'wonder' drug began to increase, according the National Archives. It was decided that penicillin for civilians should only be supplied to larger hospitals where the staff had been properly trained to administer it. Only in 1946 did it become fully available for the general public.
Telegraph
4 days ago
- Health
- Telegraph
Churchill frustrated he had to buy penicillin from US ahead of D-Day
Sir Winston Churchill was frustrated that he was forced to buy penicillin from the United States ahead of D-Day, official papers have revealed. Production of the 'wonder drug' had struggled to take hold on a large scale in Britain, despite it having been discovered in London by Sir Alexander Fleming in 1928. Attempts to produce substantial quantities of medicine from the bacteria-killing mould had not been achieved by the start of the Second World War. Churchill became increasingly frustrated that Britain had not been able to produce enough penicillin during preparations for the Normandy landings in 1944. Official papers released by the National Archive, containing handwritten notes by Sir Winston, highlight efforts to boost quantities of the antibiotic, with Britain eventually forced to import it from America. The documents were released ahead of the 81st anniversary of D-Day, the Allied invasion of Normandy on June 6 1944. In one report on Feb 19 that year, after the problem had been raised in the Commons, Sir Winston scrawled in red ink on a Ministry of Supply report noting the Americans were producing greater quantities: 'I am sorry we can't produce more.' On another paper, he complained: 'Your report on penicillin, showing that we are only to get about one tenth of the expected output this year, is very disappointing.' Elsewhere in the same file he instructs: 'Let me have proposals for a more abundant supply from Great Britain.' With preparations for D-Day ramped up, efforts to deliver enough American-made penicillin for frontline military personnel soon became a matter of urgency. Decisions needed to be made on the quantities of antibiotic imported, how much to administer to individual patients, and how to get medical staff trained in time. Most British doctors did not know how to issue penicillin – until this point, doctors had nothing available to treat infections like pneumonia, and many people died of blood poisoning after minor injuries because no drug existed that could cure them. Early in January 1944, Prof FR Fraser, the Ministry of Health's adviser on the organisation of wartime hospitals, wrote that 50,000-100,000 wounded could be expected from the second front. He suggested that the Emergency Medical Services might need as many as five billion units of penicillin per month for this. Further documents show discussions on whether the antibiotic should be supplied as calcium or sodium salts, or in tablet form. Ultimately, it was agreed that powdered calcium salts would be issued for superficial wounds and sodium salts for use in deeper ones. On May 24 1944, less than a fortnight before D-Day, Prof Fraser reported: 'Sufficient supplies of penicillin are now available for the treatment of battle casualties in EMS hospitals, but not for ordinary civilian patients.' Plans were made for casualties from the frontline in France to be brought back to coastal hospitals in Britain for treatment. On May 30 1944, a week before D-Day, hospitals were instructed to treat battlefield patients en route. The instructions said: 'In an endeavour to prevent the development of gas gangrene and sepsis in wounds, the War Office have arranged for the treatment of selected cases by penicillin to be commenced as soon after injury as possible.' Injections of penicillin were to be given to them at intervals of not more than five hours and patients would be wearing a yellow label with the letters 'PEN'. The time and size of penicillin doses should be written on it, they were told. Dr Jessamy Carlson, a modern records specialist at the National Archives, said: 'File MH 76/184 gives a glimpse into the extraordinary levels of preparation undertaken in advance of the D-Day landings. 'Only six weeks before, penicillin is just reaching our shores in quantities which will allow it to play a major role in improving the outcomes for service personnel wounded in action.' As Allied forces made inroads into Europe, restrictions on the use of penicillin for civilians began to be relaxed – but only in special cases. In July 1944, Ronald Christie, a professor of medicine, wrote to Prof Fraser to tell him: 'The War Office approves of American penicillin being used for medical conditions in service patients and for air raid casualties among civilians.' On the home front, demand for the new wonder drug began to increase, according the National Archives. It was decided that penicillin for civilians should only be supplied to larger hospitals where staff had been properly trained to administer it. It became fully available to the general public in 1946.
The Independent
4 days ago
- Health
- The Independent
Penicillin gave D-Day landings an unlikely boost, Churchill papers show
Newly released documents reveal that the D-Day landings were aided by the import of penicillin from America, as Britain struggled to produce sufficient quantities of the antibiotic. Prime Minister Winston Churchill expressed frustration in handwritten notes over Britain's inability to produce enough penicillin for the Normandy landings in 1944, leading to increased reliance on American supplies. Preparations for D-Day included decisions on the quantities of penicillin to import, dosage for patients, and training medical staff, as most British doctors were unfamiliar with its use. By May 24, 1944, sufficient penicillin was available for treating battle casualties in Emergency Medical Services hospitals, but not for ordinary civilian patients. Hospitals were instructed to administer penicillin to battlefield patients en route, with injections given at intervals of no more than five hours, marking treated patients with a yellow 'PEN' label; penicillin became fully available to the general public in 1946.
BBC News
5 days ago
- Health
- BBC News
Winston Churchill's race to secure penicillin before D-Day found in notes
Winston Churchill's push to obtain penicillin in time to treat casualties expected from D-Day has come to light in documents seen by BBC papers unearthed by the National Archives reveal the prime minister's frustration and concern over slow progress securing supplies of what was then seen to be a brand new "wonder drug".The BBC was shown the papers ahead of the anniversary of the Normandy landings on 6 June months after D-Day, the wartime prime minister called efforts "very disappointing" and bemoaned the fact the US was "so far ahead" despite the drug being a "British discovery". Penicillin was discovered in London by Professor Alexander Fleming in 1928. Despite attempts to produce a usable medicine from the bacteria-killing mould, this had not been achieved by the start of World War Two. But an Oxford team of scientists, led by Howard Florey, carried out the first successful trials. With large-scale production difficult in the UK, they took their research to the United States, where drug companies expanded the development of penicillin, blood poisoning could follow even minor wounds with no cure available. So with the anticipation of the huge military effort ahead, supplies of the drug were seen as essential. Early in 1944, the prime minister was complaining to his ministers about Britain's inability to produce it at scale. He scrawled in red ink on a Ministry of Supply report that said the Americans were producing greater quantities: "I am sorry we can't produce more".Later in the year, in response to explanations from officials, he said: "Your report on penicillin showing that we are only to get about one-tenth of the expected output this year, is very disappointing." On another report, he instructs: "Let me have proposals for a more abundant supply from Great Britain". Less than a fortnight before D-Day, health officials could report that sufficient supplies had been obtained, most from the US, but only for battle Jessamy Carlson, modern records specialist at The National Archives, said: "The files give a glimpse into the extraordinary levels of preparation undertaken in advance of the D-Day landings. "Only six weeks before, penicillin is just reaching our shores in quantities which will allow it to play a major role in improving the outcomes for service personnel wounded in action."But what's now seen as the first true antibiotic would not be fully available to the general public till 1946. A telegram in the same files shows a doctor from Cornwall, who was treating a 10-year-old child in 1944, pleading with the authorities for the medicine: "No hope without penicillin". The plea was rejected, with supplies said to be only available for military use. With antibiotics now part of everyday life (and arguably too widely used), the documents seen by the BBC shed new light on the urgent efforts by Churchill and others to secure enough of one such drug for the first time to save lives during the struggle to liberate northern Europe.
Medscape
12-05-2025
- Health
- Medscape
Reversing Inaccurate Penicillin Allergy Labeling
Accurate labeling of penicillin allergies is essential, but unconfirmed penicillin allergies may have negative effects on individual and public health, according to experts. A trend toward 'de-labeling' by testing individuals with documented penicillin allergies is gaining steam, in part as a way to reduce antibiotic use and curb the emergence of more resistant bacteria, according to Upeka Samarakoon, PhD, of Massachusetts General Hospital, Boston, and colleagues in a review article published in 2023 in the Annals of Allergy, Asthma, and Immunology . The article outlined the benefits of de-labeling and identified how patients are labeled with a penicillin allergy. Individuals acquire a penicillin allergy label either by reporting a past reaction to penicillin or displaying a reaction recorded by a healthcare provider. Removing the allergy label from a patient's medical record may involve an evaluation of reaction history and often following an in-office drug challenge, according to the authors. Why Lose the Label? Penicillin antibiotics are first-line treatments for infections commonly treated in primary care settings — strep throat, ear infections, and urinary tract infections, said Kimberly G. Blumenthal, MD, the corresponding author of the review article, in an interview. 'Inaccurate penicillin allergy labels lead to inferior clinical outcomes from using second- line treatments, which are often broad-spectrum antibiotics,' said Blumenthal, an allergist/immunologist and clinical researcher at Massachusetts General Hospital and associate professor of medicine at Harvard Medical School, Boston. 'Patients with unconfirmed penicillin allergy labels have an increased risk of treatment failures, healthcare-associated infections, and colonization or infection with resistant organisms,' she added. Proactively de-labeling patients with unverified penicillin allergies will improve their future care as they will be able to receive first-line treatments in times of need, said Blumenthal. 'Awareness of the importance of penicillin allergy de-labeling does seem to be increasing in primary care, but barriers exist for implementing de-labeling practices outside of allergy specialist clinics,' Blumenthal told Medscape Medical News . More work is needed to increase penicillin allergy de-labeling by generalists, potentially through the use of electronic health records or other decision tools and algorithms to assess patients, she said. Barriers to increased de-labeling in primary care include limited time, productivity targets, and pressure to achieve quality metrics for chronic health diseases, Blumenthal said. 'Additionally, primary care physicians report that they lack allergy knowledge and lack the resources needed for penicillin allergy evaluations,' she said. 'Potential solutions to these barriers include having a dedicated penicillin allergy de-labeling clinic, including questions on penicillin allergies during annual visits, and increasing education related to penicillin allergy de-labeling for generalists,' Blumenthal noted. Clinician's Guide to De-Labeling The use of simple allergy history tools can go a long way toward de-labeling a penicillin allergy, Blumenthal told Medscape Medical News . 'Many penicillin allergy labels lack a reaction or should not be there at all and warrant de-labeling based on history alone,' she said. For example, a patient who has subsequently taken penicillin with no reaction or had only a family history of penicillin allergy is a candidate for de-labeling, she said. For individuals who may have an allergy, risk stratification tools such as PEN-FAST can identify low-risk patients who are suitable for de-labeling in primary care, Blumenthal said. 'A patient with a PEN-FAST score of 0, in my opinion, would be appropriate for primary care de-labeling in the US. Higher-risk patients can be referred to allergy specialists,' she added. The 2023 article contains a more detailed explanation of the de-labeling process, which can be done in a few hours' time and at relatively low cost, according to the authors. Safely Ruling Out the Allergy The majority of patients who are labeled as allergic to penicillin are, in fact, not allergic, said John Kelso, MD, in a presentation on allergies at the annual meeting of the American College of Physicians (ACP), previously reported by Medscape Medical News . Patients labeled as penicillin-allergic but who have no history of severe cutaneous adverse reactions are candidates for de-labeling, Kelso said. 'Many patients go through their entire lives unable to receive the best treatment for infections because they are mislabeled as being allergic to penicillin,' he emphasized. An intradermal skin test can confirm or rule out a penicillin allergy for patients who experienced hives after a first dose of a new course of penicillin, but blood tests are not reliable, Kelso said in his ACP presentation. De-labeling has increased dramatically in the last few years, both in allergist offices and in primary care settings, driven in part by campaigns from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; the Centers for Disease Control and Prevention; and the Infectious Diseases Society of America, Kelso told Medscape Medical News . Clinicians often assume that the process of de-labeling a penicillin allergy is 'complicated, time-consuming, and dangerous,' but that is not the case, Kelso said. To begin the de-labeling process, screen patients with appropriate questions to exclude those whose prior reaction may have been immediate anaphylaxis or a late-onset severe cutaneous adverse reaction, Kelso said in an interview. Once such patients are excluded, the process simply involves administration of a dose of amoxicillin followed by a 1-hour observation period in the clinic and asking the patients to report any late onset reactions that might develop over the next day or two, he said. A large body of research exists to support de-labeling of penicillin allergies, Kelso told Medscape Medical News . 'Perhaps the most important finding is that 95% of patients who are labeled as being allergic to penicillin are not, either because the original reaction was coincidental or the allergy has been lost over time; thus, the vast majority of patients who undergo an amoxicillin challenge for penicillin de-labeling will do so uneventfully,' he noted. 'Once an appropriate history has been taken to exclude the patients who may be at risk of a more severe reaction, the remainder should be offered the de-labeling by amoxicillin challenge so that in the future they can offered the most appropriate treatment,' he said.
