What is essential in the initial treatment of diphtheria?

• A. Diphtheria antitoxin plus erythromycin or penicillin for 2 weeks
• B. Vaccination alone will suffice
• C. Steroids and antivirals are first-line
• D. No specific therapy is needed

Answer: (B)

When dealing with diphtheria, the immediate goal is to stop the toxin from causing harm and to clear the bacterial infection so that toxin production stops. The essential move is to administer diphtheria antitoxin as soon as diphtheria is suspected; this antitoxin binds circulating toxin and neutralizes it before it injures tissues. Because toxins already bound to tissues cannot be reversed by the antitoxin, early administration is crucial to prevent fatal complications such as swelling of the airway and myocarditis.

At the same time, start an antibiotic such as erythromycin or penicillin to eradicate Corynebacterium diphtheriae and halt further toxin production, which also helps prevent transmission to others. Vaccination is key for prevention, but it does not treat an active infection. Steroids or antivirals are not first-line treatments for diphtheria, and doing nothing is inappropriate.