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Uroxin 4G + fosfomycin is a combination therapy consisting of the multi-ingredient dietary supplement Uroxin 4G and the broad-spectrum antibiotic fosfomycin trometamol. Uroxin 4G is a nutraceutical formulation containing D-mannose, collagen, hyaluronic acid, chondroitin sulphate, propolis, quercetin (as Proqutin®), and the probiotic *Bacillus coagulans*. Fosfomycin acts by inhibiting bacterial cell wall synthesis through the inactivation of the enzyme UDP-N-acetylglucosamine enolpyruvyl transferase (MurA). The combination is designed to provide a synergistic effect by combining direct antimicrobial activity with the anti-adhesive properties of D-mannose, the mucosal-protective effects of glycosaminoglycans and collagen, and the anti-inflammatory and microbiome-modulating benefits of quercetin, propolis, and probiotics. This regimen is being evaluated by the University of Campania Luigi Vanvitelli in Phase 4 clinical trials (specifically the IMProBaCist-Q study) for the prevention of recurrent urinary tract infections (UTIs) and the improvement of quality of life in women.
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