Optimizing the management of acute diarrhoeal disease

We are conducting a multicentre, randomized, placebo-controlled, factorial trial enrolling children with severe acute gastroenteritis +/- severe acute malnutrition at four hospitals in southern Botswana. All children are randomized to rapid enteric molecular diagnostics (followed by targeted antibiotic therapy if a treatable cause for the diarrhoea is found) or standard care, and Lactobacillus reuteri probiotics or placebo, and followed for 60 days. Our previous pilot trial suggested that both of these interventions might lead to better growth and much less recurrent diarrhoea.