Treatment of Immunologic Reactions
Immunologic reactions are medical emergencies that must be evaluated and treated immediately to prevent long-term sequelae. Antimicrobial therapy should continue throughout the type 1 (reversal) reaction, although many clinicians will stop rifampin, especially in the presence of active neuritis. Cutaneous manifestations of a type 1 reaction generally do not require additional therapy. However, if the patient experiences loss of sensation or other peripheral nerve symptoms, corticosteroids should be started immediately to prevent permanent damage. Type 2 reactions may not respond to corticosteroids alone, and the addition of drugs such as thalidomide may be useful in these cases. Patients not responding to any therapy may benefit from clofazimine if not already taking this drug.
Pharmacotherapy. 2012;32(1):27-37. © 2012 Pharmacotherapy Publications