The Antibiotic Era: Reform, Resistance, and the Pursuit of a Rational Therapeutics

363 Pages·2014·5.34 MB·English

by  Scott H. Podolsky

The Antibiotic Era
The Antibiotic Era
Reform, Resistance, and the Pursuit of a Rational Therapeutics
SCOTT H. PODOLSKY
This book was brought to publication with the generous assistance of the
Department of Global Health and Social Medicine, Harvard Medical School.
© 2015 Johns Hopkins University Press All rights reserved. Published 2015
Printed in the United States of America on acid-free paper
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Library of Congress Cataloging-in-Publication Data
Podolsky, Scott H., author.
The antibiotic era : reform, resistance, and the pursuit of a rational
therapeutics / Scott H. Podolsky.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-42141593-2 (hardcover : alk. paper) — ISBN 1-4214-1593-3
(hardcover : alk. paper) — ISBN 978-1-4214-1594-9 (electronic) — ISBN 1-
4214-1594-1 (electronic) I. Title.
[DNLM: 1. Anti-Bacterial Agents—history—United States. 2. Drug Industry
—history—United States. 3. Drug Resistance—United States. 4. History, 20th
Century—United States. 5. Legislation, Drug—history—United States. QV 11
AA1]
RM267
615.7′922—dc23 2014014551
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For Roz and Leon Fink,
and in memory of
Lorna and Jack Podolsky
CONTENTS
Acknowledgments
Introduction
1 The Origins of Antibiotic Reform
2 Antibiotics and the Invocation of the Controlled Clinical Trial
3 From Sigmamycin to Panalba: Antibiotics and the FDA
4 “Rational” Therapeutics and the Limits to Delimitation
5 Responding to Antibiotic Resistance
Conclusion
List of Abbreviations
Notes
Index
ACKNOWLEDGMENTS
In many ways, this book grew out of my prior book project, Pneumonia Before
Antibiotics, as I’ve continued to engage in the clinic and as a historian with
issues of therapeutic autonomy, education, regulation, and innovation. Indeed,
Jeremy Greene has quipped that I should have titled this book “Pneumonia After
Antibiotics.” Since the publication of Pneumonia, I’ve had the great fortune to
become director of the Center for the History of Medicine at the Francis A.
Countway Library of Medicine, to teach with and learn from fellow members of
Harvard Medical School’s Department of Global Health and Social Medicine, to
continue to provide primary care to my patients at Massachusetts General
Hospital, and to engage with colleagues worldwide attempting to define and
promote the rational production and delivery of antibiotics. I’ve learned a great
deal in the process, and it’s a privilege to be able to give thanks in this space.
At the Countway, Kathryn Hammond Baker has been a brilliant collaborator,
continually positioning our center to support scholarship, while our remarkable
staff members always make us look good through their dedication and consistent
excellence. Special thanks go to Jack Eckert and Jess Murphy for facilitating
(and tolerating) my extensive research on Max Finland in particular; I appreciate
them all the more, knowing they work as diligently for all of our center’s users.
Zak Kohane and Alexa McCray, the Countway’s director and deputy director,
have been supportive of both our center and my own scholarship, as have Jay
Jayasankar and Roz Vogel, president and administrative head of the Boston
Medical Library. It’s an embarrassment of riches to work not only amid the
books and journals of the Countway but also amid its remarkable librarians and
staff, and I’m especially grateful to Elizabeth Bueso, Betsy Eggleston, David
Osterbur, and Julia Whalen for their ongoing wisdom and availability.
At Harvard Medical School’s Department of Global Health and Social
Medicine, it’s impossible not to be inspired and influenced by the examples of
our leaders, Paul Farmer and Anne Becker. I’m personally grateful for their
support, as well as that of Jennifer Puccetti and Rebecca Grow, in particular. My
esteemed colleagues Allan Brandt and David Jones continue to shape my
thinking and support my efforts in many ways, as they have for many years. I am
truly fortunate and grateful. Leon Eisenberg provided wise counsel at the start of
this book, and he’s greatly missed by all who were lucky enough to know him
and learn from him. At HMS itself, Dean Jeffrey Flier has created an
environment where history is a means not only of celebration but also of critical
inquiry. Across the river, I’m proud to be affiliated with Harvard’s History of
Science Department and exposed from the one side to such role models as
Charles Rosenberg and to fantastic students from the other side. Again, this is an
embarrassment of riches.
At the Massachusetts General Medical Group, I continue to learn from both
my colleagues and my patients. I’m grateful to everyone in the practice, while
special thanks go to our group’s directors during this project, Steve Levisohn,
David Finn, and Amy Schoenbaum, to my office roommate Patty Gibbons, and
to my “team” of Anne Drake, Angela McCaul, Tina Rosado, and Fred Rose,
who take such wonderful care of our patients. MGH and its Division of General
Internal Medicine provided critical funding at an early stage of the project and
have been consistently supportive of my work.
My thinking about the issues examined in this book has evolved considerably
over the past decade, and I’m honored to thank colleagues who have provided
both encouragement and critique. I’m especially indebted to my frequent
collaborator Jeremy Greene, who generously read through several versions of
the manuscript, by which time he had already provided countless leads and
shaped my understanding of the history of therapeutics more broadly. Ed Dwyer
and Fred Tauber, both long-term mentors, read through the entire manuscript, as
did Robert Guidos, Calvin Kunin, John Powers, and Dominique Tobbell, who
have been engaged with the issues described here for many years. At Harvard,
I’ve benefited from discussions with Jerry Avorn, Daniel Carpenter, Yonatan
Grad, Ted Kaptchuk, Aaron Kesselheim, and Peter Tishler, while beyond
Harvard I’ve received valuable input and insights from Robert Bud, Iain
Chalmers, Arthur Daemmrich, David Herzberg, Greg Higby, Suzanne Junod,
Claas Kirchelle, Jerry Klein, John Lesch, Stuart Levy, Nick Rasmussen, John
Swann, Ulrike Thoms, Jo Tricker, Elizabeth Watkins, and the late Mark Finlay.
The enduring influence of Harry Marks will be apparent throughout.
I extend particular thanks to the European Science Foundation’s Drugs
Networking Programme and to the hosts of a series of conferences concerning
the history (and future) of antibiotics and pharmaceuticals more generally.
Christoph Gradmann, Flurin Condreau, Anne Kveim Lie, and María Jesús
Santesmases not only individually influenced my thinking, but they also
provided environments where scholars could converse across national and
disciplinary boundaries. If the intention of such conferences was to broaden the
thinking of participants, then they were wildly successful in my case. I’m also
grateful to the hosts and audiences at the American Association for the History
of Medicine, Beth Israel Deaconess Medical Center’s Division of Pulmonary
Medicine, the Boston Colloquium on the History of Psychiatry and Medicine,
Brigham and Women’s Hospital’s Division of Pharmacoepidemiology, Clark
University’s Department of Biology, Dartmouth Medical School’s Pathology
Research and Review Seminar Series, the Food and Drug Administration, the
Massachusetts Infectious Disease Society, multiple venues at Massachusetts
General Hospital, the New England Tuberculosis Symposium, and Yale
University’s Program in the History of Science and Medicine for close attention
and feedback.
Now that I live on both sides of the archival fence, I more fully appreciate
just how much work goes into the acquisition and curation of archival
collections. This book could not have been completed without the efforts of the
archivists and librarians at the locations listed at the end of this book. Special
thanks to Bill Davis, Janice Goldblum, and Stephen Greenberg for making going
over and beyond the call of duty seem easy.
I am particularly grateful as well to Mark Leasure, Robert Guidos, and Kathy
Cortez at the Infectious Diseases Society of America and to Stuart Levy at Tufts
University School of Medicine for making their private collections available to
me without in any way attempting to censor my conclusions. In both cases, their
engagement with issues around antibiotic resistance was matched by their
generosity and open-mindedness.
I’d like to acknowledge Oxford University Press for permission to draw from
my article “Antibiotics and the Social History of the Controlled Clinical Trial,
1950–1970,” Journal of the History of Medicine and Allied Sciences 65 (2010):
327–67, and to acknowledge Johns Hopkins University Press (JHUP) for
permission to revise and reprint excerpts from “Chapter 2: Pharmacological
Restraints: Antibiotics and the Limits of Physician Autonomy,” in Jeremy A.
Greene and Elizabeth Siegel Watkins, eds., Prescribed: Writing, Filling, Using,
and Abusing the Prescription in Modern America (Baltimore: Johns Hopkins
University Press, 2012), pp. 46–65. My debt to JHUP only starts there, however.
Executive editor Jackie Wehmueller has again provided consistent support, good
humor, and wise counsel in equal measure, while I’m grateful to Glenn Perkins
for his careful copy editing and to Courtney Bond for her thoughtful production
editing.
Finally, it’s always a privilege to be able to thank my family. Neither my