Joining me today is David Luci, President and Chief Executive Officer of Acurx, who will start by providing a corporate update and outlook. patents, along with patents in Israel, Japan, India, Australia, and Korea, all of which protect key aspects of the company's product pipeline. During the quarter, the company raised a total of approximately $3.1 million of gross proceeds through purchases under its equity line of credit. However, we're very excited to see that this new guidance explicitly states, and it now formalizes what had been published previously in the New England Journal of Medicine, but now specifically for C.

This new guidance refers back to a lineage of other FDA guidances going back to at least 2019, discussing the feasibility and the requirements for a single trial. What is very important is the new guidance, which is a final guidance, it's not a draft guidance, applies it specifically to C. I guess recurrent obviously it's recurring but treating the three at the end of the day, it's still sort of the same treatment, correct? The interesting thing about the new guidance is that for the first time, it talks about not just treatment and prevention of recurrence, it talks about long-term prevention of disease in a prophylactic fashion.

Certain bile acids are critical in actually suppressing the growth of C. those bacteria that are producing the bile acids that suppress the growth of C. Just quickly, you know, the FDA guidance also mentions or, like, emphasizes thoughtful selection of patient populations, especially when it comes to elderly populations. I was wondering if maybe you could talk to us about how your protocols also might align with this part of the guidance, this guidance as well.

What went well
  • Bolstered its balance sheet, ending Q1 2026 with $9.3 million in cash (up from $7.6 million at year-end) and, in April 2026, closing a registered direct offering (825,085 shares/pre-funded warrants at $3.03) plus a concurrent private placement of short-term warrants - funding that, with the ELOC, covers the exploratory rCDI trial.
  • Kept operating spend lean, with Q1 R&D of $0.3 million and G&A of $1.4 million, narrowing the net loss to $1.7 million from $2.1 million a year earlier.
  • Received a potentially transformative regulatory signal: the FDA issued FINAL guidance (the week before the call) formalizing a possible single adequate and well-controlled trial with confirmatory evidence for C. difficile - a standard Acurx believes it can meet via its mechanistic, in vitro, animal-model and microbiome data - and scheduled an FDA meeting for summer 2026.
  • Continued to expand its patent estate to 10 granted patents (five U.S. plus Israel, Japan, India, Australia and a new Korean patent), including composition-of-matter and method-of-use claims and a patent covering ibezapolstat's use to treat CDI while reducing recurrence.
  • Presented new preclinical data at ESCMID Global (Munich) showing systemically absorbed pol IIIC compounds reduced MRSA tissue burden while preserving gut microbial diversity, supporting the ACX-375C program.
What went wrong
  • The company remains pre-revenue and dependent on dilutive financing, having raised ~$3.1 million via the ELOC in the quarter and completed a further equity/warrant financing in April to fund operations.
  • The recurrent-CDI trial is only in startup/site-qualification mode, with the first patient expected around August 2026, so pivotal data and the acute-CDI Phase 3 remain well in the future.
  • The favorable one-trial standard still must be applied to Acurx's specific ibezapolstat regulatory path, which the company can only confirm through its planned FDA meeting.

Guidance Changes

MetricPeriodCurrent guidance
Cash positionAs of March 31, 2026$9.3M in cash (vs $7.6M at Dec 31, 2025)
April 2026 financingQ2 2026Registered direct offering of 825,085 shares/pre-funded warrants at $3.03 plus short-term warrants for up to 1,650,170 shares at $2.78; registration statement now effective
rCDI exploratory trial start~August 2026In startup mode (site qualification); first patient targeted around August 2026
FDA meeting on Phase 3 designSummer 2026Scheduled to discuss applying the new one-trial standard and confirmatory evidence to ibezapolstat
Recurrence follow-up windowPhase 3 designPatients to be followed ~8 weeks (two months) post-treatment, matching approved anti-recurrence agents (VOWST, Rebyota)

Performance Breakdown

MetricYoYNote
Research & development expense (Q1) $0.3M (vs $0.6M) $0.1M lower manufacturing and $0.2M lower consulting as prior-year trial-preparation costs rolled off.
General & administrative expense (Q1) $1.4M (vs $1.6M) $0.1M lower professional fees and $0.1M lower legal costs.
Net loss (Q1) $1.7M (vs $2.1M) Continued low operating spend.
Diluted net loss per share (Q1) $(0.62) (vs $(2.15)) Smaller loss on ~3.39M shares outstanding.
Cash, equivalents & investments $9.3M ~$3.1M of ELOC proceeds in the quarter, ahead of the April registered direct offering.

Earnings Call Themes & Trends

TopicPrevious mentionCurrent periodTrend
Regulatory pathwayOne-trial standard proposed (NEJM)FDA final guidance formalized for C. difficile; FDA meeting set for summer 2026Up
Funding / runway$7.6M year-end cash$9.3M cash plus April equity/warrant financing to fund the rCDI trialUp
rCDI trial executionProgram announcedSite qualification underway; first patient ~August 2026Up

More on Acurx Pharmaceuticals, Inc.

Reported 2026-05-12 · figures from the Acurx Pharmaceuticals, Inc. Q1 2026 earnings call.

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