Therapeutic Approaches Beyond Antivirals for Pediatric Infectious Diseases in Low- and Middle-Income Countries

Pediatric infectious diseases remain a leading cause of morbidity and mortality among children under 5 years of age in low- and middle-income countries (LMICs). Respiratory syncytial virus and other viral pathogens are major contributors to acute lower respiratory tract infections, while diarrheal diseases continue to drive preventable mortality and long-term growth impairment. In many LMIC settings, pathogen-specific antiviral therapies are limited by cost, availability, and delayed clinical access, necessitating reliance on alternative strategies for prevention and management. This review provides an expanded and clinically detailed synthesis of non-antiviral approaches, including strengthened supportive care, integrated management frameworks, passive immunization, maternal vaccination, nutritional rehabilitation, zinc supplementation, infection prevention, and antimicrobial stewardship. Particular emphasis is placed on preterm and low-birth-weight infants, who experience amplified vulnerability due to immature pulmonary and immune systems and reduced transplacental antibody transfer. Integration of these layered interventions within maternal, neonatal, and primary healthcare systems offers a pragmatic pathway to reduce hospitalizations, mortality, and long-term morbidity in resource-constrained settings.