Which treatment is the treatment of choice for salicylate overdose?

• A. Activated charcoal alone
• B. Garlic therapy
• C. Hemodialysis
• D. Diuretics

Answer: (C)

Salicylate overdose becomes life-threatening when the patient has significant toxicity, acid-base disturbance, or renal dysfunction, and the toxin is readily removed from the blood by dialysis. Hemodialysis rapidly lowers serum salicylate levels and corrects the associated metabolic acidosis and electrolyte imbalances, providing the most effective clearance in severe cases. While early measures like activated charcoal can limit absorption if given soon after ingestion, and intravenous sodium bicarbonate helps alkalinize serum and urine to enhance excretion, these are slower or supportive compared to dialysis in critical toxicity. Diuretics do not reliably enhance salicylate clearance, and garlic therapy has no role. Therefore, in severe salicylate overdose, dialysis stands out as the treatment of choice due to its ability to rapidly remove the toxin and stabilize the patient.