Sulfa Drugs: the Rise and Fall of Sulfanilamide

A few corrections and clarifications: * At the end I tease that penicillin replaced sulfonamides, which as you could tell from my description of current uses of sulfa drugs, isn’t true. Sulfa drugs are still in use and have other uses that they didn’t know in the 1930s. When I was writing that line, I should’ve said “…replaced it as the most *popular* antibacterial” * Remember from the last video in the antibiotics series we defined an antibiotic as an antibacterial produced by another microbe. I didn’t define it again in this video since I thought it would be repetitive, but clearly, sulfanilamide is an antibacterial, but not produced by a microbe, so it’s not an antibiotic. * Bayer has different pronunciations depending on your country of origin. The proper German is more like “buy-err”. American English speakers can pronounce it like I did * There should be a hyphen between Interessen and gemeinschaft when I spell out what IGF stands for. Most of my sources had it as one word. * I’ve been pronouncing Pyogenes “pie-ohh-jeans” my whole life, but it turns out most people say “pie-ahh-jen-us”

In 1957 when I was 9 years old I developed an extremely severe form of tonsillitis that was threatening to block my airway. I lived in Rochester Minnesota, so I was under the care of the Mayo Clinic and the doctors there gave me one of the sulfa drugs to try and reduce the infection sufficiently to operate. Unfortunately there is a rare genetic intolorance to sulfas that leads to a delightful reaction called Stevens/Johnson disease which, if not caught fast enough causes reactions in the skin and mucus membranes that basically leaves you looking like a burn victim—if it doesn’t kill you first. I spent about a week wrapped in wet dressings being wheeled around the Mayo Clinic on a cart while the worked the problem, and luckily ended up with virtually no damage to my skin, but it was a close call. Sulfas may have been something of a miracle drug, but they could kill you under certain circumstances.

Sulfa saved my grandfather's life when he was a teenager. He got the tip of his finger cut off and developed blood poisoning, almost died. After cutting off more and more of the finger in an attempt to get ahead of the infection, he was about to lose his whole arm with still no guarantee of surviving when a new doctor at the hospital decided to try sulfa on him. Needless to say, it saved his life and arm too.

As someone allergic to sulfa drugs it was really interesting to learn more about them!

I take sulfasalazine to control my Crohn’s, and one of the side effects was increased heart palpitations. My doctors were stumped (I had all kinds of heart tests to figure out what was going on but my heart was fine). I did some of my own reading and found that sulfasalazine can cause folic acid deficiency, so I started taking a folic acid supplement in addition to the folic acid in my multivitamins. And that cleared up the issue. But thanks to this video, I understand why it causes a folic acid deficiency. And I did not know it had anti bacterial properties. Cool!

In WWII my father sustained an open shrapnel wound; the medic poured sulfa powder on the open wound as he was evacuated to a hospital ship. Many doses of that and maybe penicillin once he got back to US saved his life.

I am anaphylactic allergic to sulpha drugs. Found out first hand when they tried it as the second antibiotic to defeat a persistent sinus infection. Only after I had a reaction did I find out my grandmother was allergic to sulfa based drugs as well. So they’re not for everyone. Really fascinating video though. Thank you for sharing.

Ah! I am allergic to sulfa drugs so I had to watch this! Great to see a video about this kind of medication.

I can't take sulfa drugs because I'm severely allergic to them. I had an anaphylactic reaction, hived up, and my body stopped regulating its temperature when I had my tonsils out when I was four. It ended up so bad I forgot how to talk and had to relearn again. This video is so informative and so glad to have found this channel.

This was interesting to me as I had an allergic reaction to a sulfa drug when I had amoebic dysentery in India in the late 1970s. Since then, I notice that if I have South Asian doctors, they always notice that and ask where and why I took this medication.

Some of the stories I read as a kid were set in WW II, and "sulpha" being poured into wounds was commonly mentioned. Until this video, though, I had no idea of why it fell out of use...it was one of the drugs often referred to as a "wonder drug". The truth is, it saved many soldiers' lives in WW II. Nice to know it's still used for a few things.

I am deathly allergic to Sulfa drugs. I had never been prescribed any until my late 30's. I became really sick, and ended up in the hospital. I get every single side effects, except the last one. I don't want the last side effect.

Hello. This is a wonderful video with great production value. You should have more subscribers and views. But as a medical student I think it might be worth mentioning a few things. 1. Sulfa Antibiotics are still widely used today. Because they control the metabolism of folate as mentioned in 14:20, they have a synergistic action with Trimethoprim, which also modulates folate metabolism, but at a different step. Currently marketed under the brand Bactrim the Trimethoprim/Sulfamethazole hybrid is still widely used today, especially as a second-line drug in UTI (Urinary Tract Infections) and infections in immunosuppressed patients (like HIV patients) 2. While unrelated to the folate metabolism, it turned out sulfa drugs can be used for a lot more than antibiotics. Thiazide, a diuretic (and thus a antihypertensive) is a widely used sulfa drug that regulates the activities of ion channels in the kidney. In another example, Sulfonylureas, which are also sulfa drugs are used as an oral glucose controlling agent in DM (though these are not widely used today - they have a too high risk of hypoglycemia). 3. I'm pretty sure you were talking about sulfasalazine when you were talking about sulfa drugs used in UC (Ulcerative Colitis). I'm really not sure is sulfa is the active component here-they belong to the 5-ASA family (5-Aminosalicylate) family and I'm pretty sure that 5-ASA is the principal active component. Sulfa might have a auxillary action, though-there is not yet clear consensus on how 5-ASA Drugs really work. Overall, wonderful video. We don't learn a lot about the history of drugs in medical school, and I've always found the history of pharmacologic research-especially their unlikely origins from dye companies-a highly fascinating topic.

So very interesting. My Great-Grand mother always said she was "allergic to sulfa drugs" when asked about allergies to medications. She was born in 1903. By the time I was at the doctor's with her - it was the 1990s and I'd never heard of them since nobody was using them in modern medicine. Great video!

I had known that dyes were inextricably tied to the discovery of antibiotics but I never knew that dyes and medicines stayed linked for so much longer afterwards. Really cool! I heard once that TNT was another product that was discovered in the course of dye research and that it sat on the shelf for a while before anybody figured out it had another use

I believe the highly toxic phenothiazine drugs were also invented from aniline dyes. I never understood how researchers thought to use dyes as medicines. Amazing!

I was told by a doctor and two different dentists that the reason my teeth were so bad and discolored as a child was because my mother had been given Sulfa drugs while she was nursing me. Wonder if there are any actual studies that show this happening.

In 1985 I was given Sulfa by U.S. Army doctors to treat Prostatitis, or infection of the prostrate. I ended up with a 105 plus fever and red rash outbreak from head to toe. It was terrible. I subsequently saw an Air Force urologist who proscribed vibramycin and that did the trick. For the next 30 years I wore a red dog tag along with my Army dog tags, which read “Allergic to Sulfa Drugs.” To this day, I make sure that annotation is on all my medical records!

IIRC there was a sensitivity issue with sulfa drugs as as well. While they still worked as a bacteriostat, about one out of ten people who took them experienced a systemic allergic reaction, much like some people have an aspirin allergy.

Thanks for a great video! Many in the English-speaking world think penicillin was the the first systemic antibacterial drug. Without sulfonamides, many more injured soldiers on both sides would have died prior to penicillin's arrival late in WW2 . Professor Domagk received a Nobel prize for his development of sulfonamides.