As the article by Restrepo et al1 on the systemic use of itraconazole (Fig 1) illustrates, we are now in the midst of an era of "designed" antimycotic agents. Prior to the late 1970s, the only effective antimycotic agents were chance finds from the large, unfocused screening programs of the 1940s and 1950s. Those decades saw the testing of thousands on thousands of soil actinomycetes, fungi, and bacteria for antibacterial, antifungal, antiviral, and antitumor activity. The screening programs resulted in hundreds of antibacterial antibiotics. Many of these antibiotics became extremely important therapeutic agents that are still useful today. At the time, however, they were fortuitous finds, often from odd or exotic locales. Thus, tetracycline came from farm soil in upstate New York, cephalosporin from sewage in Sardinia, Italy, and the presently used penicillin from a melon in Peoria, Ill.
In the several decades that have transpired, random screening has given
Rippon JW. A New Era in Antimycotic Agents. Arch Dermatol. 1986;122(4):399-402. doi:10.1001/archderm.1986.01660160055016