• Metaprim is bactericidal combination of Sulphamethoxazole and trimethoprim. • Metaprim is effective even in the multi-resistant infections. • Metaprim produces a sequential double blockade of bacterial metabolism, giving a level of activity many times greater than that obtained by either drug alone. • Metaprim provides effective antibacterial activity against a wide range of infections caused by Gram-positive and Gram-negative bacteria.