###### Abstract
Patients may benefit from rapid and appropriate diagnosis, avoiding erroneous prescription of antibiotics, concomitant side effects, and antibiotic-resistance related issues. Of note, a study with 414 patients performed in India using a molecular multiplex panel registered the use of antibiotics in 90% of patients with a viral causative agent [12]. Molecular methods have undoubtedly revolutionized clinical virology in the past decades and helped to improve our understanding of the epidemiology of virus-associated AGE. Using NAT, norovirus was shown to be a key AGE pathogen causing nearly a fifth of all cases of AGE [13]. With the advent of recently introduced multiplex PCR panels, a comprehensive and simultaneous analysis of up to 20 different pathogens is possible within a very short time and minimal hands-on time. This allows for a syndromic testing approach since these panels test for pathogens associated with a specific infectious syndrome. As of yet, these panels are primarily available for respiratory tract and gastrointestinal infections. Although multiplex testing is increasingly utilized in many industrialized countries, data from, e.g., Africa or tropical settings, are scarce. Data on the clinical impact (i.e., antibiotic prescription, auxiliary testing, isolation, length of hospital stay) of syndromic panels, even from industrialized regions, are lacking at large and are, to some extent, controversial. According to the health technology assessment report by [PERSON] et al., multiplex testing for gastrointestinal pathogens leads to a higher number of positive results than conventional testing. However, the clinical significance of these additional positive results is unclear as test-treatment trials are lacking. Therefore, no conclusion can be drawn whether the additional positive results lead to overdiagnosis or improved patient management [14]. Further important hurdles for their implementation are high costs, the need for sophisticated equipment, and the lack of evidence-based criteria for their clinical use. Especially for bacterial AGE pathogens, it is imperative to discriminate between true infection and colonization. Quantitative data from PCR-based methods might help to distinguish active infection from colonization but warrant careful interpretation and standardization [15; 16; 6]. Unlike bacterial AGE, there is no approved therapy for most viral infections, except for symptomatic treatment and isolation. Importantly, rotavirus vaccines are now widely used for the prevention of rotavirus-associated gastroenteritis. To control the success of vaccination programs, reliable detection methods are of importance. This gives rise to the notion that molecular methods are not only important for individuals but also for public health in many countries worldwide. Finally, the cost-effectiveness of molecular methods is hard to assess not only in resource-rich countries, as prerequisites as laboratory equipment and test costs, reimbursement, and other variables are significantly different from country to country. Having this in mind, it is evident that clinical guidelines do not recommend universal testing of all patients presenting with diarrbal symptoms. Here, we summarize what is known about the use of multiplex syndromic panels for the detection of virus-associated AGE in resource-limited regions.