Jichi Medical University, Japan
Dr. Harumi Gomi is Associate Professor of Medicine, Center for Clinical Infectious Diseases, Jichi Medical University, Japan. She graduated from Okayama University Medical School, Japan in 1993. She completed her residency in internal medicine at Beth Israel Medial Center, New York, and infectious diseases fellowship at University of Texas-Houston Medical School. She obtained hermaster’s degree in public health at Johns Hopkins Bloomberg School of Public Health. She was appointed as Assistant Professor at Division of Infectious Diseases, Southern Illinois University School of Medicine, Illinois.
International clinical practice guidelines on acute cholangitis and cholecystitis were first published in 2007 as Tokyo Guidelines 2007 (TG 07). There had been no international practice guidelines on this common disease by then. TG 07 has been updated and published as Tokyo Guidelines 2013 (TG 13). The guidelines provide open access free of charge for readers. The significant efforts have been made to provide standardized care for patients with acute biliary infections for better clinical outcomes. In revising TG 07, the Tokyo Guidelines Revision Committee was developed consisting of internationally renowned experts including surgeons, gastroenterologists and infectious diseases specialists. In the revision process, vigorous literature search was performed for currently existing medical documents by Pub Med. Through the revision processes, very limited data on patients with acute biliary tract infections was found, which was up to date and relevant to the current advanced medical practice over all. There were many areas of uncertainties such as updated epidemiology of the causative organisms, prevalence of antimicrobial resistance, an optimal antimicrobial therapy, an optimal timing and modalities of biliary drainage, and duration of antimicrobial therapy. This presentation will provide the introduction of the international clinical practice guidelines, focusing on antimicrobial therapy, and discuss limitations of the guidelines and future challenges to improve them.