Lori Guelman, a nurse practitioner in outpatient urology conducted an innovative research study and quality improvement (QI) project to improve the care of women with acute cystitis at Stanford Health Care. This article discusses Lori’s recent research publication and QI innovations.

Optimizing Antibiotic Management for Acute Simple Cystitis in Women: An Evidence-Based Roadmap for the Primary Care Ambulatory Setting

Lori Guelman is a nurse practitioner in the outpatient urology clinic at Stanford Health Care (SHC). Lori and her colleagues see many women with symptoms of acute simple cystitis, typically described as an acute urinary tract infection (UTI). Lori had a concern that not all her colleagues in primary care were following published guidelines on antibiotic management of simple cystitis.  This is an important issue because of the need for antibiotic stewardship to prevent the development of bacterial resistance due to antibiotic overuse.

To answer this question, Lori formulated a research plan that included a survey of providers and a chart review of prescribing practices for acute cystitis. Following data collection and analysis, Lori disseminated the study results at SHC, created a “smart set” in epic to match best practices, and published a research paper in the Urologic Nursing. Click here to read the published article.


Antibiotics are often inappropriately prescribed for an uncomplicated urinary tract infection (simple cystitis) among females seeking treatment in primary care ambulatory clinics. This survey and retrospective chart review, performed at a single academic center, leveraged antibiotic stewardship principles to develop an electronic smart set to standardize antibiotic prescriptions.

Guelman, L., Hsieh, C.D., Pine, K., & Lough, M.E. (2020). Optimizing antibiotic management for acute simple cystitis in women: An evidence-based roadmap for the primary care ambulatory setting. Urologic Nursing, 39(6), 283-292. doi:10.7257/1053-816X.2019.39.6.283


Article By: Mary E. Lough & Lori Guelman

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