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The article considers, on the basis of analysis of archival documents, issue of Soviet-Chinese cooperation in field of production of penicillin in the 1950s. The main attention is paid to history of construction of penicillin plant in Shijiazhuang. It is demonstrated that it was carried out on preferential terms for China and it was under special control of the USSR government. The building of plant was bound by great difficulties conditioned by range of project, specifics of production conditions in China, special requests of customer, necessity to manufacture non-standard equipment. The implementation of this project of enormous humanitarian significance was at the same time manifestation of concurrence between the USSR and the USA for geopolitical and ideological influence in East Asia.

The article, on the basis of declassified archival documents, considers the issue of centralized state distribution of penicillin in the USSR in the second half of 1940s. The mechanism of determining the need in medication using special coefficient is presented. It is demonstrated that in conditions of acute shortage, this approach became an attempt to ensure physical accessibility of medication for patient. However, by the end of 1940s, when acute shortage was overcome, free state supplies created preconditions for mismanagement and misuse at national and local levels, that affected timing and volume of supplies of antibiotic to medical institutions, as well as quality of medication supplied to patient. The district hospitals of provincial towns occurred in the worst condition. The article presents the facts testifying that penicillin supply solved not only health problems, but also domestic and foreign policy problems of the post-war USSR.

Hans Emmanuel Enoch (1896-1991) was born in Hamburg, the son of a manufacturer of sera and vaccines. Upon his father's death, he took charge of the Hamburg Serum Werke. Following the rise of Hitler, he came to be pilloried in the Nazi press for allegedly having poisoned the population of Hamburg and was imprisoned for a time. He immigrated to England in 1935 where he had secured a position with the International Serum Company in Norwich. Following the outbreak of war, he was interned as an enemy alien, eventually ending up in Canada. In 1941, he was permitted to return to England, but wartime conditions prevented him from continuing to manufacture sera. At about this time, penicillin was making the headlines, and coupled with accounts of its miraculous properties, was the news that all production was reserved exclusively for the armed forces. Enoch decided to meet the public clamour for penicillin by producing a crude version which he termed 'vivicillin.' News of this spread globally, and he came to incur the disdain of Howard Florey for the attendant publicity. Notwithstanding this, vivicillin was to prove itself effective and its use led to the saving of lives.

Portugal did not participate in World War II but was one of the first countries in the world to receive penicillin for civilian use. The Portuguese Red Cross began to import the antibiotic from the United States of America in 1944 and appointed a controlling committee to oversee its distribution, due to the small amount available. In 1945, as world production increased, penicillin began to be distributed through the normal channels. An important role in its regulation was played by the official department responsible for controlling pharmaceutical and chemical products in Portugal, the Comissão Reguladora dos Produtos Químicos e Farmacêuticos (Regulatory Committee for Chemical and Pharmaceutical Products). Penicillin was imported as a raw material from 1947 and the first medicaments containing penicillin, prepared in Portugal, were released into the commercial circuit in 1948. A laboratory had been established in 1942 by the Comissão Reguladora for the analytical verification of medicaments and medicinal products with the aim of certifying their quality and minimizing the number of products with no attested therapeutic efficacy. The number of medicaments analysed by this laboratory increased substantially from 72 in the year of its foundation (1942) to 2478 in 1954, including, after 1948, medicaments containing penicillin. The aim of the present paper was to elucidate the role of the Comissão Reguladora dos Produtos Químicos e Farmacêuticos in regulating and controlling the distribution of penicillin in Portugal during the 1940s and 1950s.

While medical historians have paid ample attention to the introduction of antibiotics and their impact on hospital-based practice during and after the Second World War, the multiple issues surrounding their use in Scottish hospitalsare sorely lacking in current discussions. Drawing on an extensive yet underused range of materials including patient treatment records, oral histories and medical correspondence, this paper explores the introduction of penicillin for civilian treatment at the Royal Infirmary of Edinburgh during the closing stages of the War. It highlights the success of the drug in clinical treatment as well as its shortcomings, offering an alternative view of its initial impact on surgical practice.

Penicillin's trajectory towards becoming an effective antibacterial chemotherapeutic agent took place during World War II. Its strategic military value was immediately recognised by the Allies, and mass production was undertaken with the prime objective of meeting the needs of the armed forces. News of its development came to be widely reported on in the media and is examined here. These reports frequently combined accounts of penicillin's prodigious clinical effectiveness with the fact that it was to remain unavailable to the civilian population essentially until the war had ended. More penicillin was to be made available to the civilian population in the United States than in Britain, but the sense that it was severely rationed remained as high. It was in response to this that the idea of "homemade penicillin" was hatched. News of this was also widely promulgated by both the British and American media. Although the numbers treated with penicillin produced in this way was never to be significant, knowledge of the existence of such endeavours may have served to assuage in some measure the feelings of frustration felt by the civilian population at penicillin's non-availability.

This paper focuses on the motives and long-term effects of the momentous decision to build a world-class biomedical research laboratory, the International Center for Chemical Microbiology, at the Istituto Superiore di Sanità in Rome, rather than develop domestic production of penicillin to meet the needs of a destitute postwar Italy. An institutionalist approach will provide a richer vision of the intersections of scientific and national political history in postwar Italy and the Cold War. The Center failed in its modernising mission due to an insular mentality producing an 'enclosure effect' against the State, the healthcare system and the pharmaceutical industry. The absence of a scientific base together with an economic policy of 'liberal protectionism' that placed premiums on import tariffs and the licensing of foreign products explains the path dependency of the pharmaceutical industry during the postwar years and its demise in the 1960s.

Objective: Sexually transmitted diseases (STDs) constitute a major public health concern in developing countries. Their interest lies mainly in their diagnosis and their early treatment. Owing to lack of health education and poor living conditions inherent in underdevelopment, self-medication is common practice in these Third World countries. Therefore, the illegal sale of drugs is an important phenomenon in Africa and Asia., Methods: An investigation, with a view to evaluating the importance of drug sales in the parallel market for the treatment of urethral discharge in Dakar, was carried out in 50 different locations in the working-class districts of the capital from 13 February to 6 March 1997. These drugs, obtained from vendors in the illegal market, were tested and analyzed using the standard physicochemical methods., Results: The most frequently proposed drugs to treat male urethritis are: ampicillin 250-mg capsules (44%); oxytetracyline 250-mg capsules (24%); and cotrimoxazole 450-mg tablets (12%). In most cases (88%), these drugs were sold unpackaged; 12% were sold in blisters. Furthermore, in 90% of cases, the expiry date was not indicated. The dosage and duration of treatment were correct in only 6% of cases. The physicochemical analysis was based on the external appearance, the identification, and the dosage of the active principle. Of these drugs offered by street vendors, 53.1% had an unusual appearance; they were mainly ampicillin 250 mg (21 of 22 samples) and oxytetracycline 250 mg (6 of 12 samples). Furthermore, all active principles were identified as positive, with the exception of ampicillin 250 mg, for which only one sample of the 22 was positive; the others appeared to be flour, with no trace of the active principle., Conclusion: Given the extent of these illegal sales of drug and their harmful consequences for the health of the population, adequate measures should be taken to eradicate this blight. For this mission to succeed, public authorities, health professionals and populations should combine their efforts.

Background: We have investigated the gastrointestinal transit time of, the influence of food intake on, the disintegration of, and the pharmacokinetics of amoxicillin in a modified-release form., Methods: Radiolabelled modified-release tablets of amoxicillin and placebo tablets were administered, in an open three-way, randomized, crossover design, as single doses during omeprazole treatment, to six male healthy subjects during fasting and non-fasting conditions. Radioscintigraphic images and plasma samples were obtained., Results: The estimated mean (and range) gastric emptying time of the modified-release tablet after drug administration was 0.3 h (0.1-1.0 h) during fasting conditions, 4.3 h (1.7-5.0 h) after a light breakfast, and 4.9 h (1.9-18.0 h) after a heavy breakfast. The small-intestinal transit time during fasting conditions was 4.7 h (2.9-6.9 h) and was not significantly changed after light or heavy breakfast intake. The relative bioavailability of the modified-release tablet was 55%, compared with a commercially available amoxicillin immediate-release tablet., Conclusion: The modified-release tablet of amoxicillin administered postprandially apparently increases the amoxicillin release time in the stomach. The relevance of its use for anti-H. pylori treatment can be questioned.

The data of case histories of the year of 1989 of seven Hungarian hospitals and also the 1990 and 1991 data of two hospitals were collected and integrated in a database. Consumption of antibiotics were represented in DDD (Defined Daily Dose)/1000 hospital day. These data were compared with the data of the drugs delivered by the hospital pharmacy in one of the mentioned hospitals between 1989 and 1992. It was concluded that data based on case histories represent better the real antibiotic consumption than those of the hospital pharmacy. Reason of this phenomenon is the fact, that considerable amount of drug supply gets out of institutions. Great differences were observed between the seven hospitals in the total amount of antibiotic consumption and between the different antibiotic groups as well. Drugs most frequently used were tetracyclines, broad spectrum penicillins, sulfonamides and aminoglycosides. Consumption of penicillins was decreasing. Regarding new drugs only utilisation of quinolones was increasing. It was concluded, that structure of antibiotic selection did not follow the recommendations of the medical literature. The authors suggest that "antibiotic policy" should be introduced in Hungarian hospitals so as to imporve antibiotic utilisation.

We distinguish and review aspects of the history of two models of triage: egalitarian and utilitarian. Egalitarian triage is widely and successfully practiced in battlefield medicine, as well as in the emergency room and the ICU. Utilitarian triage has been sporadically practiced and typically collapses under the pressure of public scrutiny. Unfortunately, the two models tend to be conflated, confusing our understanding of the past and confounding our ability to plan for the future.

The pharmaceutical industry is not supplying the penicillin preparations that are required for the treatment of syphilis. For those in whom penicillin hypersensitivity is suspected there is a need for a safe injectable alternative that is effective if given once daily or, preferably, at two- or three-day intervals. Existing treatments for chancroid, lymphogranuloma venereum, and granuloma inguinale are described, but even collectively there are few cases and treatments for other sexually transmitted diseases merit priority. Treatments for scabies and pediculosis pubis, although not perfect, are reasonable. There is a need for better local treatment for condylomata acuminata and systemic immunological methods, including those that increase cell-mediated immunity, deserve attention. The same is true for molluscum contagiosum. There is an urgent need for an effective, safe treatment of herpes genitalis that is able to eradicate the virus from the host. If it is proved that the herpes virus is responsible for carcinoma of the cervix this could then be the most serious sexually transmitted disease as in many countries such carcinomas are responsible for approximate seven times more deaths in women than is syphilis in men and women together. The limitations of prophylactic methods in preventing all possibility of infection with one or more of the sexually transmitted diseases are discussed.