First of all, Kuwait has a big drug resistance problem, in part because drugs have been overused, and it's the same thing on the Indian subcontinent. You even have antibiotics ending up in fresh water that people are consuming. This is one of the big risks when antibiotics-laden effluent from manufacturers ends up in the sewage. However, because of these rates, Kuwait has diagnostic strategies and tests in a lab located close to patient care that we don't have. Just to clarify, I don't think we need them today, but we need to be ready to employ them if we have to.
The biomarkers I was speaking about were on the last slide I had, the procalcitonin tests. There is a point-of-care version, which is used in Nordic countries, and also another test, called CRP or C-reactive protein. The other one, which is used in hospitals a lot—especially in Europe and the Middle East, but, increasingly, some places in North America are also looking at this—is the procalcitonin test, especially in intensive care units, as a way of helping antimicrobial stewardship teams decide when to stop antibiotics.
Antimicrobial stewardship, as Dr. Shevchuk said, is very important, but sometimes you are transitioning somebody from an intravenous to an oral antibiotic. You are still exposing the patient to an antibiotic, so that alone may not reverse resistance. It's better if you can actually get them off the antibiotics. It's still not proven that this will work, but it's important. As someone else said, if you can actually prevent infections with good infection control, then you don't need antibiotics in the first place, so that's another important strategy, be it through vaccination or better infection control strategies.