The incidence and significance of fevers during treatment with antithymocyte globulin for aplastic anaemia

Antithymocyte globulin (ATG) is a foreign protein used widely to treat apla stic anaemia (AA). Febrile reactions occurring during its administration ma y be impossible to distinguish clinically from fever due to sepsis, and are therefore routinely treated with intravenous antibiotics after collection of blood cultures. A statistically highly significant difference was found in positive blood cultures between 39 AA patients who developed feller duri ng ATG therapy and 38 febrile neutropenic patients with acute leukaemia, su ggesting that most fevers developing during ATG treatment are not due to in fection, It may therefore be reasonable to consider early discontinuation o f intravenous antibiotics in patients who are clinically stable and have no proven sepsis.