Neutropenia, Febrile

Also known as: Febrile neutropenia / Neutropenic fever

DrugDrug NameDrug Description
DB00681Amphotericin BAmphotericin B shows a high order of in vitro activity against many species of fungi. Histoplasma capsulatum, Coccidioides immitis, Candida species, Blastomyces dermatitidis, Rhodotorula, Cryptococcus neoformans, Sporothrix schenckii, Mucor mucedo, and Aspergillus fumigatus are all inhibited by concentrations of amphotericin B ranging from 0.03 to 1.0 mcg/mL in vitro. While Candida albicans is generally quite susceptible to amphotericin B, non-albicans species may be less susceptible. Pseudallescheria boydii and Fusarium sp. are often resistant to amphotericin B. The antibiotic is without effect on bacteria, rickettsiae, and viruses.
DB00355AztreonamA monocyclic beta-lactam antibiotic originally isolated from Chromobacterium violaceum. It is resistant to beta-lactamases and is used in gram-negative infections, especially of the meninges, bladder, and kidneys. It may cause a superinfection with gram-positive organisms.
DB00520CaspofunginCaspofungin (brand name Cancidas worldwide) is an antifungal drug and the first member of a new drug class called the echinocandins, as coined by Merck & Co., Inc. It is typically administered intravenously. It shows activity against infections with Aspergillus and Candida, and works by inhibiting β(1,3)-D-Glucan of the fungal cell wall.
DB01413CefepimeCefepime is a fourth-generation cephalosporin antibiotic developed in 1994. Cefepime is active against Gram-positive and Gram-negative bacteria, with greater activity against both than third-generation antibiotics. Cefepime is usually reserved to treat severe nosocomial pneumonia, infections caused by multi-resistant microorganisms (e.g. Pseudomonas aeruginosa) and empirical treatment of febrile neutropenia.
DB00537CiprofloxacinCiprofloxacin is a second generation fluoroquinolone that has spawned many derivative antibiotics.[A178870] It is formulated for oral, intravenous, intratympanic, ophthalmic, and otic administration for a number of bacterial infections.[L6469,L6472,L6475,L6478,L6481,L6484,L6487,L6490,L6493] The first ciprofloxacin containing product was FDA approved on 22 October 1987.[L6463]
DB00099FilgrastimChemotherapy-induced neutropenia (CIN) is a common and serious complication of myelosuppressive chemotherapy. It is associated with significant morbidity and mortality and can increase the cost of cancer therapy. In these cases, colony stimulating factor is necessary to restore important cells for immune function [A35591]. For over twenty years, granulocyte colony-stimulating factors (G-CSFs; filgrastims) have been a pillar of treatment and prevention of CIN, and have been found to reduce the risk of neutropenia across various patient settings, decrease the incidence of febrile neutropenia, reduce the incidence of infection, reduce the requirement for treatment with antibiotics, and accelerate neutrophil recovery [A35591]. Filgrastim is a recombinant, non-pegylated human granulocyte colony stimulating factor (G-CSF) analog. It is marketed as the brand name _Neupogen_ by Amgen (initially approved in 1998) and as _Nivestym_, a biosimilar agent by Pfizer. Nivestym was approved by the FDA on July 20th, 2018 [L3735]. Between 1998 and the present, Neupogen/filgrastim has been approved for various indications [L3744]. _Tbo-filgrastim_, which is marketed by Sicor Biotech and FDA approved on August 29, 2012, contains the same active ingredient as Neupogen and is biologically similar, but it is formulated to be short-acting [F719]. On March 6, 2015, the FDA approved the biosimilar Zarxio (filgrastim-sndz) and is indicated for use in the same conditions as Neupogen. Zarxio is marketed by Sandoz [L3742].
DB13200LipegfilgrastimLipegfilgrastim, previously known as XM22, is a pegylated, recombinant granulocyte colony-stimulating factor (G-CSF) that was synthetized using a highly site-specific glycoPEGylation technology [A32665]. It is used as an alternate to [DB00019] for prophylactic use in cancer patients receiving chemotherapy and at risk for developing chemotherapy-induced neutropenia. Since July 2013, lipegfilgrastim is marketed by the EMA as Lonquex for subcutaneously injection, where it is administered once following cytotoxic chemotherapy for each chemotherapy cycle in adult patients being treated with cytotoxic chemotherapy for malignancy. It aims to reduce the duration of neutropenia and the incidence of febrile neutropenia. Neutropenia and febrile neutropenia (FN) are frequent and potentially fatal complications that occur from myelosuppressive anticancer treatments [A32665]. Severe chemotherapy-induced neutropenia and febrile neutropenia significantly increases the risk for life-threatening infection and sepsis. Granulocyte colony-stimulating factors (G-CSFs) were introduced in the 1980's to the clinical setting to stimulate neutrophil proliferation and differentiation, thereby reducing the duration and severity of chemotherapy-induced neutropenia [A32665]. Lipegfilgrastim is a covalent conjugate of [DB00099] with a single methoxy polyethylene glycol (PEG) molecule via a carbohydrate linker consisting of glycine, N-acetylneuraminic acid and N-acetylgalactosamine [L2441]. The average molecular mass of lipegfilgrastim comprises 18,798 Da for [DB00099], 203 Da for GalNAc, 338 Da for glycylsialic acid and approximately 20,000 Da for PEG [L2449]. PEG moiety protects the active molecule from enzyme degradation, which allows longer half-life of drug and less frequent dosing-schedule in addition to acceptable safety and efficacy profile [A32665].
DrugDrug NameTargetType
DB00681Amphotericin BErgosteroltarget
DB00681Amphotericin BCytochrome P450 3A4enzyme
DB00355AztreonamPenicillin-binding protein 3target
DB00520CaspofunginSolute carrier family 22 member 1transporter
DB00520CaspofunginP-glycoprotein 1transporter
DB00520CaspofunginSolute carrier family 22 member 6transporter
DB00520CaspofunginSolute carrier organic anion transporter family member 1B1transporter
DB00520CaspofunginSolute carrier organic anion transporter family member 1B3transporter
DB00520CaspofunginCytochrome P450 3A4enzyme
DB00520Caspofungin1,3-beta-glucan synthase component FKS1target
DB01413CefepimeSolute carrier family 22 member 5transporter
DB01413CefepimeSolute carrier family 15 member 1transporter
DB01413CefepimeSolute carrier family 15 member 2transporter
DB01413CefepimePenicillin-binding protein 2target
DB01413CefepimePeptidoglycan synthase FtsItarget
DB01413CefepimePenicillin-binding protein 3target
DB01413CefepimePenicillin-binding protein 2target
DB00537CiprofloxacinDNA gyrase subunit Atarget
DB00537CiprofloxacinDNA topoisomerase 4 subunit Atarget
DB00537CiprofloxacinDNA topoisomerase 2-alphatarget
DB00537CiprofloxacinCytochrome P450 1A2enzyme
DB00537CiprofloxacinCytochrome P450 3A4enzyme
DB00537CiprofloxacinCytochrome P450 3A5enzyme
DB00537CiprofloxacinCytochrome P450 3A7enzyme
DB00537CiprofloxacinP-glycoprotein 1transporter
DB00537CiprofloxacinPotassium voltage-gated channel subfamily H member 2target
DB00537CiprofloxacinDNA gyrase subunit Atarget
DB00537CiprofloxacinDNA topoisomerase 4 subunit Atarget
DB00537CiprofloxacinDNA topoisomerase 4 subunit Btarget
DB00537CiprofloxacinDNA gyrase subunit Atarget
DB00537CiprofloxacinMultidrug resistance protein MdtKtarget
DB00537CiprofloxacinGyrase Atarget
DB00537CiprofloxacinDNA gyrase subunit Atarget
DB00537CiprofloxacinMultidrug and toxin extrusion protein 1transporter
DB00537CiprofloxacinMultidrug and toxin extrusion protein 2transporter
DB00537CiprofloxacinSerum albumincarrier
DB00099FilgrastimGranulocyte colony-stimulating factor receptortarget
DB00099FilgrastimNeutrophil elastasetarget
DB13200LipegfilgrastimGranulocyte colony-stimulating factor receptortarget
DrugDrug NamePhaseStatusCount
DB14336Angelica sinensis root2Completed1
DB00681Amphotericin B4Terminated1
DB00438Ceftazidime4Not Yet Recruiting1
DB00760Meropenem4Not Yet Recruiting1
DB00319Piperacillin4Not Yet Recruiting1
DB01606Tazobactam4Not Yet Recruiting1
DB00512Vancomycin4Not Yet Recruiting1
DB00681Amphotericin BNot AvailableCompleted1
DB00760MeropenemNot AvailableCompleted1
DB06149TeicoplaninNot AvailableCompleted1
DB00512VancomycinNot AvailableCompleted1