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This report contains the first therapeutic results with the multiple combination rifampicin + isoniazid + sulfamethoxazole + trimethoprim in the treatment of malaria. Clinical symptoms declined rapidly and parasites were cleared from the erythrocytes. Tolerance was excellent. This fixed combination is outstandingly practicable, with few problems with compliance.

Following the brief information on a new malaria treatment with the fixed multiple combination Cotrifazid (rifampicin + isoniazid + sulfamethoxazole + trimethoprim) in Chemotherapy [1995;41:396–398], very good results are reported for the treatment of 61 patients with various forms of malaria. The tolerance was found to be good. Some relevant fundamental considerations (chemoresistance, synergism/antagonism, fixed multiple combination, switching from monotherapy to combination therapy) and the implementation of the principle of a ‘multidisease therapy’ are discussed.

Since 1970, when the lifelong monotherapy with dapsone (DDS) in leprosy could be replaced by short-term combination therapy with rifampicin + isoniazid + protionamide-!-DDS (Isoprodian-RMP), chemotherapeutic research was faced with two problems: (1) to find alternative treatment regimens for cases of intolerance, and (2) to work out forms of therapy allowing a further reduction of the average treatment time of 2 years. The present paper describes the attempts made to find solutions to these problems. With two new combinations, alternatives have become available, and the average treatment time is shortened to 6 months. Both combinations are also effective in tuberculosis.

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