Bugged by Antibacterials?

These days there are a lot more concerns about the overuse of medications'especially antibiotics'that could cause even more health problems in the long run. But what about the precautions we use to prevent infections to begin with? Hand washing is considered one of the most important ways to prevent transmission of infectious agents from one person to another. It is common for hospitals to have guidelines that say if a nurse touches a wound, good hand-washing techniques with antibacterial soap should be routine. But what about the rest of us? Even in 2000 antibacterial agents were present in three quarters of liquid soaps and nearly a third of bar soaps on the market. There has been some concern about the potential for bacteria to develop resistance to the agents in these products, reducing their effectiveness. Should we be using antibacterial soap? Prevention of the transfer of bacteria is especially important if you have immune deficiency or if you have any open wounds. With that in mind, let's take a closer look at the use of antibacterial hand products. Starting from the beginning, antibacterial products are made to deal with bacteria. In one study of households using antibacterial hand-washing and other cleaning products, no differences were seen in the reported symptoms of infections between those using such products and households that did not routinely use products with antibacterial ingredients. The study's authors suggested that because transmitted infections that lead to symptoms that were reported tend to be viral, antibacterial products cannot be expected to have a significant effect. So if you plan to kill viruses, you will need to look at other methods. If you are dealing with other pathogens, the effect might be a bit different. A group of diaper changers were tested for the differences between basic soap and antibacterial products on the risk for infection. Most of the effect in reducing risk of disease was seen in the hand scrubbing itself. However, an additional 20% risk reduction was suggested for those who use antibacterial soap. Going even further, after the use of antibacterial soap there was up to five hours of antibacterial activity on the skin. In another study households that routinely used an alcohol-based hand gel experienced less transmission of respiratory illnesses in the homes where children were enrolled in day care (and carrying home respiratory and gastrointestinal bugs on a routine basis). But before you head out to buy a large supply, you should know that some pathogens are less susceptible to alcohol hand gels. If you work in a post office in Washington, D.C., you might want to know that such products were far less effective in dealing with anthrax spores. Interestingly, hand-scrubbing time and ability to wash away the germs after scrubbing seemed to have more effect. Before we make our decision whether we should use such products and what to choose, let's revisit the whole issue of hand washing. In general, a good scrubbing can help loosen and remove bacteria regardless of the use of antibacterial products. Fingernails notoriously harbor bacteria and protect bacteria from mechanical removal. Scrubbing with soap and a nailbrush are important features of hand washing to effectively remove bacteria, especially if you are dealing with immune deficiency, wounds, or someone else's food. If you are thinking about using antibacterial hand-washing products, consider the reasons you have to justify their use. For instance, do you deal with open wounds, immune deficiency (your own or someone else's), or other people's food? If so, it could be worth it to consider using such products. In any case, improving your hand-washing methods will be even more important to accomplishing your goal. Fields-Gardner is the director of services for The Cutting Edge, an HIV nutrition company. She is a member of the International AIDS Society and the American Dietetic Association's Dietetic Practice Group on HIV and AIDS. She has written a book on HIV medications and a guide to nutritional management of HIV for clinicians. Write to Fields-Gardner at cade@hivplusmag.com.