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Sulfadoxine + pyrimethamine + artesunate is a fixed-dose combination antimalarial therapy used primarily for the treatment of uncomplicated malaria caused by Plasmodium falciparum. This combination is classified as an artemisinin-based combination therapy (ACT) and is recommended by the World Health Organization (WHO) for areas with chloroquine resistance[3][6]. Artesunate is a semi-synthetic derivative of artemisinin that rapidly reduces parasite biomass through production of reactive metabolites. Sulfadoxine and pyrimethamine are folic acid antagonists; sulfadoxine inhibits dihydropteroate synthase while pyrimethamine inhibits dihydrofolate reductase, resulting in sequential blockade of folate synthesis in the parasite[5][6]. The synergy between these drugs enhances efficacy and helps delay resistance development. The regimen typically involves once-daily dosing of artesunate for three days with a single dose of sulfadoxine-pyrimethamine on day one[1][3].
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