Antibiotics for Children With Severe Diarrhoea (ABCD)

The challenge:

Since the World Health Organization (WHO) has recommended management package for acute diarrhea (ORS, zinc, and feeding advice), significant reductions in diarrhea associated mortality have occurred. However, over half a million children continue to die annually as a result of acute diarrhoeal episodes. Moreover, rates of mortality in young children in the 90 days following an episode appear at least as high as mortality that occurs during the acute episode.

Our Approach:

Given the long-term benefits of antibiotic administration, optimizing antibiotic treatment of acute diarrhea episodes in very young children with severe disease may be an opportunity to significantly reduce diarrhea associated deaths in the 90 days following presentation for acute diarrhea and may also improve growth. ABCD, led by the WHO, is a multi-site randomized, double-bind, placebo-controlled clinical trial attempting to evaluate the ability of an antibiotic (azithromycin) in reducing mortality within 90 days of the acute diarrhoeal episode and improve nutritional status over the same period. The study will be looking at the proportion of children dying per arm and mean change in length per arm and also incidence of hospitalizations per arm.


Investigators are still recruiting participants. The study is estimated to be completed by the end of 2022.