Could Fish Medicine Save Your Life?

This forgotten WWI antiseptic could be the key to fighting antibiotic resistance

An antiseptic used in WWI hospitals has been revived after seven decades, and is showing great promise in preventing the common cold, and could be the key to fighting antibiotic resistance - one of the biggest ever threats to global health.

The simple antiseptic, made from coal tar, was replaced by penicillin after the war, and fights both viral and bacterial infections in an entirely different way - one that could prevent pathogens from mutating to outsmart our medications.
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Called Acriflavine, the antiseptic is derived from coal tar, and comes in the form of a reddish brown or orange powder.

It was first used in the early 1900s as a topical treatment to prevent flesh wounds from getting infected, and was widely used in hospitals and homes to treat everything from urinary tract infections and gonorrhoea until the 1940s, when penicillin came to the fore.

It’s now been more than 70 years since penicillin became the most important tool we have to fight bacterial infections, and its days appear to be numbered.

Many of the deadliest pathogens in the world have managed to mutate into forms that our penicillin-based drugs can’t recognise or destroy, and now antibiotic-resistant bacteria kill roughly 700,000 people each year around the world.

In addition to common hospital superbug, methicillin-resistant Staphylococcus aureus (MRSA), experts are now concerned that gonorrhoea is about to become resistant to all remaining drugs, and there are already resistant strains of tuberculosis, pneumonia, and E. coli being circulated.
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So what makes Acriflavine a better fit than penicillin for our very serious superbug problem?

Gantier and his team revisited the drug that showed so much success in the early 20th century, because until now, no one had investigated how it actually works.

"Early scientific literature notes its antibacterial qualities in test tubes, but its very effective action on the skin has never been fully defined," Gantier told Bill Condie at Cosmos.

The team investigated its behaviour in human cell cultures, and figured out that it binds to the DNA of the patient to kick the immune system into action when a viral infection was taking place.

At the same time, the antiseptic also binds to viral DNA in the body, slowing the spread of viruses as the immune system prepares itself.

If you Google acriflavine, you will soon see that one of  it's major uses these days is as a fish medicine. Back in my teen years, when I worked in a tropical fish store, we used to make an all purpose "fish tonic", which consisted largely of methylene blue and acriflavine. The blue and the yellow acriflavine made it a lovely green color.  We had a huge (OK, maybe 500 g) bottle of powdered acriflavine, and the medicine was made up by adding a teaspoon or so of each (no measurements actually involved), plus a little salt and some other secret (but probably ineffective) ingredients into a gallon jar, mixing it, and bottling it. A few teaspoons would turn a tank green for a couple of days, until the dyes were degraded or absorbed. It was remarkably effective for a large number of fish diseases.

Once when I had a smashed finger nail that was starting to go bad, I drilled a hole in the nail to let out the pus and flushed it with the TNT special tonic (TNT aquarium was the name of the fish store). It stopped the infection in its tracks, at the cost of a green finger tip for a few days.

I'm surprised a DNA intercaliting agent is being considered for internal use, though. They are general presumed to be carcinogenic based on the possibility of DNA damage.