Strategies to Reduce Mortality Among Children Living With HIV and Children Exposed to HIV but Are Uninfected, Admitted With Severe Acute Malnutrition at Mulago Hospital, Uganda (REDMOTHIV): A Mixed Methods Study

This study protocol describes an open label randomized controlled trial investigating whether empiric use of ceftriaxone versus standard-of-care antibiotics (ampicillin plus gentamicin) will reduce mortality among children living with HIV (CLHIV) and children exposed to HIV but uninfected (CHEU) admitted with severe acute malnutrition. The trial involves 300 children (76 CLHIV and 224 CHEU) randomized to receive either ceftriaxone or standard-of-care treatment for one week. The primary outcome is in-hospital mortality, with secondary outcomes including length of hospitalization, growth parameters, and pathogen sensitivity patterns.