and Embase for the period 2008-2015, randomized controlled trials and systematic reviews with or without meta-analysis were included. Within the framework of a guideline synopsis, relevant guidelines were sought. Evidence level and bias risk were used for quality testing. RESULTS: Particular emphasis is given to symptom-oriented diagnostics. Fosfomycin trometamol, nitrofurantoin, nitroxolin, piv- mecillinam or trimethoprim are recommended equivalently for the treatment of uncomplicated cystitis. Fluoroquinolones and cephalo- sporins are not recommended. For uncomplicated slight-moderate py- elonephritis preferably the oral formulations namely cefpodoxim, ceftibuten, ciprofloxacin or levofloxacin are recommended. An asymp- tomatic bacteriuria is not to be treated. In recurrent urinary tract in- fections, non-antibiotic prevention measures are recommended. CONCLUSIONS: Physicians, who are involved in the treatment of uncomplicated urinary tract infections, should familiarize themselves with the revised recommendations for the selection and dosage of antibiotic therapy of the updated clinical guideline. Antimicrobial stew- ardship aspects have significantly influenced the therapeutic recom- mendations. A broad implementation in all treatment groups is necessary to ensure a sustainable antibiotic policy and to improve care. Source of Funding: None MP23-08 LACK OF UNIFORMITY AMONG UNITED STATES GUIDELINES FOR DIAGNOSIS & MANAGEMENT OF ACUTE, UNCOMPLICATED CYSTITIS Lauren N. Wood, Andrew R. Medendorp*, Melissa Markowitz, Shlomo Raz, David A. Haake, Ja-Hong Kim, Los Angeles, CA INTRODUCTION AND OBJECTIVES: Acute, uncomplicated urinary tract infection (UTI) remains one of the most common bacterial infections seen in inpatient and outpatient clinical settings in the United States. Since uncomplicated UTI is treated in a variety of different settings, guidelines from professional medical societies are expected to be well aligned. Our aim was to compare guidelines for diagnosis and treatment of acute, uncomplicated UTI from medical specialties in the U.S. and confirm uniformity. METHODS: The most up to date published guidelines within the fields of family medicine, obstetrics & gynecology, internal medicine, female pelvic medicine & reconstructive surgery, and infectious dis- eases in the U.S. were reviewed. RESULTS: All guidelines recommended the use of symptoms and urine dipstick only to diagnose uncomplicated UTI. Some societies did not recommend urine dipstick in cases of recurrent UTI or for pa- tients with classic UTI symptoms with no underlying conditions or competing diagnoses. None recommend the use of urine culture to confirm diagnosis. All guidelines endorsed nitrofurantoin, trimethoprim- sulfamethoxazole, and fosfomycin as first-line agents. Discrepancies existed in the classification of fluoroquinolone and beta-lactam antimi- crobials, with most guidelines describing them as second-line, while others considered them first or third-line agents. Amoxicillin and ampi- cillin, antibiotic agents with high resistance rates in the U.S., were described as important to avoid only by some U.S. guidelines. None mentioned the FDA black box warning for Cipro. (Table available for presentation). CONCLUSIONS: Comparison of guidelines from various spe- cialties revealed important differences in the approach to the treatment of acute, uncomplicated UTI. This lack of uniformity is likely to contribute to the varying clinical management of patients with UTI, emphasizing the need for more consistent guidelines that may improve physician adherence. With few exceptions, urine culture with sensitivity was not recommended for the diagnosis or treatment of UTI by any of the guidelines reviewed. However, the widespread use of empiric antibiotic therapy for UTI can contribute to growing antibacterial resistance pattern in the U.S. and impede efforts for antibiotic stewardship. Source of Funding: None MP23-09 COMPARISON OF POSTOPERATIVE CATHETER-ASSOCIATED URINARY TRACT INFECTION (CAUTI) RATES IN THE UROLOGIC PATIENT WITH A SUPRAPUBIC CATHETER VERSUS TRANSURETHRAL CATHETER Jason Warncke*, Brittan Sutphin, John Hohenmeyer, E. David Crawford, Brian Flynn, Denver, CO INTRODUCTION AND OBJECTIVES: Urinary tract infections (UTIs) are the most common type of healthcare-associated infection. Among UTIs acquired in the hospital, 75% are catheter-associated urinary tract infections (CAUTI). CAUTI has gained much attention, as in 2008 Medicare regulations ceased reimbursement for costs related to nosocomial CAUTIs. Traditional teaching has been that suprapubic catheters (SPC) are associated with less risk of CAUTI than transure- thral catheters (TUC). However, studies directly comparing the CAUTI rate in patients with SPC versus TUC are lacking, particularly in the postoperative Urologic patient. Thus, in this study we aim to compare the CAUTI rate with SPC versus TUC in the postoperative Urologic patient. METHODS: We retrospectively reviewed and compared the medical records of 354 patients over a 5-yr period that underwent Urologic surgery. The SPC group consisted of patients that underwent SPC placement at the time of concomitant autologous rectus fascia pubovaginal sling (PVS) by a single surgeon (BJF). SPC placement was accomplished using the T-Spec device from Swan Valley Medical. The TUC group consisted of patients that underwent TUC placement using an 18 Fr Foley at the time of open radical prostatectomy (RP) by a single surgeon (EDC). Patients without a SPC or TUC and patients with both were excluded from the study. The primary outcome of comparison was the CAUTI rate (defined by the 2017 CDC guidelines) between the SPC and TUC cohorts. A Fisher’s exact test was performed to deter- mine if the difference in CAUTI rate between the two cohorts was sta- tistically significant (p<0.05). RESULTS: 252 patients were included, including 145 (57.6%) in the SPC group and 107 (42.5%) in the TUC group, mean age 54.5 and 61.5 yrs, respectively. The mean catheter duration at the time of CAUTI for the SPC and TUC groups were 21.3 and 16.0 days, respectively (p¼0.79). The mean catheter duration for the TUC group with and without CAUTI was 25.4 and 14.7 days, respectively (p¼0.14). The overall CAUTI rate when catheter duration was less than 15 days compared to greater than 15 days was 3.3% and 5.0%, respectively (p¼0.39). The CAUTI rate for the SPC group was 2.1% versus the TUC group 7.5% (p¼0.039; OR 3.82). CONCLUSIONS: In this study of postoperative Urologic pa- tients, SPC was found to have a statistically significant lower rate of CAUTI when compared to TUC. This information may help guide pro- viders when choosing the appropriate bladder drainage modality for their patients, particularly in the postoperative Urologic setting. Source of Funding: none MP23-10 INCREASING INTERNATIONAL PROSTATE SYMPTOM SCORE PREDICTS PRESENCE OF BACTERIA WITHIN THE BLADDER IN THE ABSENCE OF URINARY TRACT INFECTION Petar Bajic*, Michelle Van Kuiken, Bethany Burge, Eric Kirshenbaum, Alan Wolfe, Cara Joyce, Kristin Baldea, Larissa Bresler, Ahmer Farooq, Maywood, IL INTRODUCTION AND OBJECTIVES: Bacteria have been identified in urine deemed sterile by standard culture and have been shown to influence lower urinary tract symptoms (LUTS). We define the relationship between International Prostate Symptom Score (IPSS) and the bladder microbiome. e284 THE JOURNAL OF UROLOGY â Vol. 199, No. 4S, Supplement, Friday, May 18, 2018