Book Review: Examining a Panacea

By the 1980s and 1990s, when it had finally become apparent that such discussions could not take place without simultaneously discussing antibiotics prescribed to humans, antibiotic resistance had become a fully politicized topic. In the sobering era of HIV, bovine spongiform encephalopathy (mad cow disease), and an apparent host of “coming plagues,” such scientists as Joshua Lederberg and Stuart Levy brought increased attention to the resistance problem. This yielded a series of reports in both Europe and the United States, increased surveillance of resistant bugs, and, ultimately, increased focus on both antibiotic prescribing and hygienic practices. These new reports, combined with increased public attention, meant that physicians and their patients could once again work together, for their individual sake and for that of society, in promoting health and preventing unnecessary illness.

Penicillin, beyond the clear organization of its arguments, is full of fascinating archival references and anecdotes concerning events, scientists, and even individual cows from around the world. My only criticism concerns the title itself: Penicillin is in many ways as much about antibiotics broadly as about a single compound or even a brand alone. The different classes of antibiotics that followed penicillin have each had their own significance. For instance, the first "broad spectrum” antibiotics, the tetracyclines and chloramphenicol, helped usher in the modern era of pharmaceutical marketing, and even pharmaceutical branding itself, in the 1950s. A focused examination of this and other antibiotic developments and their repercussions could at times have lent more nuance to the story.

Bud is indeed skilled at drawing on the antibiotic story broadly when he needs to. This skill allows him to cast a critical light on the overall issues of implementing antibiotics and broader pharmaceuticals at a critical juncture in their history. Bud’s careful analysis makes his text important to policy makers, clinicians, and patients alike. As Bud reveals, in many ways the antibiotic era has come full circle. Yet, as he points out, it remains unclear exactly where it will end.

Scott Podolsky directs the Center for the History of Medicine based at the Countway Medical Library at Harvard Medical School and is the author of Pneumonia before Antibiotics: Therapeutic Evolution and Evaluation in Twentieth-Century America.