How a cantaloupe helped change medicine

By: Ellen Thiel, MPH , Merative Real-World Data and Analytics Service Team

When Alexander Fleming returned from vacation in September of 1928 and saw that mold had grown in some of the petri dishes, he probably wasn’t pleased. When he saw the effect the mold had on the Staphylococcus bacteria in his petri dishes, he realized it was a significant discovery. He began work with his team to isolate pure penicillin without knowing how significant penicillin would become.

How significant? In 2021 alone, more than 5.5 million patients had outpatient pharmacy claims for an antibiotic, according to the Merative? MarketScan? Research Database. Fleming didn’t focus on its clinical use though. And the drug we know today as penicillin wasn’t successfully used in patients until 1942.

A team at Oxford University began the clinical-focused work in 1938 after Dr. Howard Florey read Fleming’s paper on his discovery. Extracting the penicillin proved difficult though. It wasn’t until 1940 that Florey’s team had a viable version. But it worked so well in its initial use in mice that it was given to a human with a life-threatening infection.

Producing enough penicillin became the next challenge. But the work generated more interest, and more researchers became involved. They realized that they needed a more productive source than the strain Florey’s team was using. Again, it was an accident that led to the next major advancement. A lab assistant in Peoria, Ill., found a better source in 1941 when her moldy cantaloupe produced a lot more penicillin than the initial strain. Researchers at other US institutions generated even greater yields, first by using X-rays, then with ultraviolet radiation.

Producing the drug for large-scale use while a war was raging was the next hurdle. Alfred Newton Richards, the chair of the Committee on Medical Research of the newly created US Office of Scientific Research and Development brought four pharmaceutical companies together to collaborate. This involvement of the became instrumental in eventually producing the volume of penicillin needed to treat war casualties and eventually, civilians.

The rest, as they say, is history. Infections from something that could be life-threatening transformed into something easy to treat, in most cases. There are still challenges of course. Antibiotic resistance, something that concerned Fleming enough that he mentioned it when accepting his Nobel Prize in 1945, caused 1.27 million deaths in 2019.

The problem of antibiotic resistance is one area where Merative can help. With clinical development and data management solutions like Merative Clinical Development, clinical decision support tools like Micromedex?, and data from MarketScan that can provide valuable information on unnecessary use of antibiotics that can lead to resistance. The combination of technology, expertise and collaboration, can lead to amazing innovations, with or without a cantaloupe.

Resources

Discovery and Development of Penicillin – American Chemical Society

?The real story behind penicillin by Dr. Howard Markel

?Global burden of bacterial antimicrobial resistance in 2019 – The Lancet