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Scientific knowledge and clinical trials in cultural context

Case study | |

In the early 1900s, German scientist and physician Paul Ehrlich, whose work led to the introduction of Salvarsan as a “magic bullet” to treat syphilis, believed that the best way to treat bacterial infection was to eradicate the causative organism through a long and powerful course of treatment. 

Ehrlich’s “treat hard, treat long” mantra has been contested for some years. Research has found that treatments lasting 2, 3, 5 and 10 days can be equally effective in treating otitis media in children. However, contemporary clinical trials and practices still rely on assumptions stemming from Ehrlich’s earlier understanding of infection. For example, inflammatory markers are used to measure the presence of causal organisms and to assess the subsequent effectiveness of an antibiotic regimen. However, inflammatory reactions can continue well after the infection has been countered, which means that overreliance on inflammatory markers can result in unnecessarily long durations, increasing the risk of ABR. This culturally contingent understanding of microbes, eradication and inflammation became embedded within early clinical trial programmes, which stipulated that new antibiotics must be compared to already existing treatment regimens. 

 

 

Photo by Mark Fletcher-Brown on Unsplash

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