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Azithromycin + sulfadoxine + pyrimethamine + LLIN is a combination regimen used for intermittent preventive treatment in pregnancy (IPTp). It was primarily studied in a Phase 3 randomized controlled trial in Papua New Guinea to reduce the incidence of low birth weight, malaria, and sexually transmitted infections (STIs) in pregnant women. The regimen consists of a fixed-dose combination of sulfadoxine and pyrimethamine (SP), the macrolide antibiotic azithromycin, and the provision of a long-lasting insecticide-treated net (LLIN). Sulfadoxine and pyrimethamine act synergistically to inhibit *Plasmodium falciparum* folate synthesis, while azithromycin provides broad-spectrum activity against reproductive tract infections and additional antimalarial effects. The LLIN serves as a physical and chemical barrier against mosquito vectors.
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