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Acetyl sulfisoxazole is an ester prodrug of the sulfonamide antibiotic sulfisoxazole. It is a synthetic analog of para-aminobenzoic acid (PABA) and acts as a broad-spectrum antibacterial agent. The drug works by competing with PABA for the bacterial enzyme dihydropteroate synthase, thereby inhibiting the incorporation of PABA into dihydrofolic acid—the precursor to folic acid. This inhibition blocks bacterial folic acid synthesis and de novo synthesis of purines and pyrimidines, resulting in cell growth arrest and death. Acetylation makes the compound less water-soluble; it is hydrolyzed in vivo to active sulfisoxazole after oral administration. Acetyl sulfisoxazole is often used in combination with erythromycin for treating acute otitis media caused by *Haemophilus influenzae*[1][2][3][5][6].
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