The Daily Med

THE DAILY EDITIONSUNDAY, 8 NOVEMBER 2026

Case of the Day · Clinical Reasoning

Fever and flank pain suggest upper-tract infection.

A 31-year-old at 24 weeks’ gestation has dysuria, fever, rigors and unilateral flank tenderness. She is stable and tolerating oral fluids; dipstick is nitrite-positive.

What is the best next step?

Drug Corner

Pharmacology in practice

URINARY ANTIBACTERIAL

Nitrofurantoin (oral)

Indication: Susceptible uncomplicated lower urinary tract infection; not renal parenchymal infection.
Mechanism: Bacterial reduction products damage multiple cellular targets.
Interactions: Antacids containing magnesium trisilicate may reduce absorption; reduced renal function compromises urinary exposure and increases risk.
Important adverse effect: Pulmonary reactions and peripheral neuropathy; stop and assess new respiratory or neurologic symptoms.
Dosing: Formulation and local guidance determine regimen; 100 mg modified-release twice daily for 3 days is a common adult uncomplicated-cystitis course. Check renal function/product label.
Sources: SmPC: https://www.medicines.org.uk/emc/product/11976/smpc

Paper of the Day

Research, without the noise

Neurology · Acute ischemic stroke

Mechanical Thrombectomy 24 to 72 Hours after Large-Vessel Ischemic Stroke

LATE-MT studied thrombectomy 24–72 hours after last known well in selected large-vessel ischemic stroke. The publication reports improved functional outcomes in its imaging-selected population; the findings should not be generalized to all late presenters. Full numerical outcome details were not accessible in the source record reviewed for this draft.

Authors: P. Yang and Others

Published: 23 October 2026 · New England Journal of Medicine

DOI: 10.1056/NEJMoa2609362

Read the original paper →

Journal Watch

What's new in medicine?

Pulmonology · COPD

A phase 2a, double-blind, randomised, placebo-controlled trial of the myeloperoxidase inhibitor, mitiperstat, in participants with chronic obstructive pulmonary disease

A phase 2a study evaluated investigational mitiperstat in COPD; early-phase results are hypothesis-generating and do not establish a clinical role.

Gastroenterology · Colorectal screening

Efficacy of artificial intelligence in detecting precancerous lesions among a colorectal cancer screening population undergoing surveillance colonoscopies in Italy: a randomized control trial (GENIAL-CO Follow-Up study)

This follow-up study assessed AI-assisted lesion detection during surveillance colonoscopy; detection outcomes should not be equated with proven cancer prevention.

Infectious diseases · Primary care

Rapid Respiratory Microbiological Point-of-Care Testing and Antibiotic Use in Primary Care: A Randomized Clinical Trial

A randomized trial found rapid multiplex testing reduced same-day antibiotic prescribing in selected acute respiratory infection visits; subgroup effects varied, so testing complements clinical assessment.

Today's Topic

Build your clinical knowledge

Urology · Prostatitis

Prostatitis: distinguish acute infection from chronic symptoms

Diagnosis / Testing

Acute bacterial prostatitis causes urinary symptoms, pelvic/perineal pain and often systemic illness. Obtain midstream urine culture; obtain blood cultures and blood count when systemically unwell. Do not massage the prostate.

Treatment / Care Decisions

Start empiric antibiotics promptly for acute bacterial disease and tailor to cultures/local resistance. Chronic bacterial prostatitis requires microbiologic evaluation and prolonged culture-directed therapy; chronic pelvic pain syndrome is managed differently.

Risk Assessment / Prognosis / Epidemiology

Sepsis, retention, immunosuppression or failure to improve warrants escalation and assessment for abscess. PSA can rise during acute inflammation and is not useful for acute diagnosis.

Pathophysiology / Basic Science

Acute bacterial infection involves prostatic tissue; chronic bacterial disease may persist in ducts, while chronic pelvic pain syndrome can occur without demonstrated infection.

Further reading: EAU Guidelines on Urological Infections (2026 update).