Hand washing is perhaps the single most important weapon in fighting the spread of infection. Whether to use plain soap, antibacterial soap or alcohol-based hand sanitizers remains open for debate. The effectiveness of the product to clean and sanitize hands is only part of the issue. The possibility of bacteria becoming resistant to antibiotics as a result of using antibacterial cleansers is cause for concern.
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When exposed to antibiotics, bacteria change to reduce or eliminate their susceptibility to a specific antibiotic. By developing resistance, the bacteria become more difficult or even impossible to treat. Any time bacteria are exposed to an antibiotic, some organisms are unaffected while others die. These resistant strains then multiply and become more prevalent. Overexposure or improper antibiotic use promotes bacterial resistance. Antibiotics are only effective against bacteria, not viruses.
Alcohol is the active ingredient in hand sanitizers. The alcohol, usually ethanol, isopropanol or n-propanol in concentrations between 60 to 85 percent, deactivates bacteria and viruses without using antibiotics. These alcohols deactivate a broad range of microbial agents and are more effective at killing microbes than antibacterial or plain soaps. Additionally, the alcohol quickly evaporates, limiting the time bacteria and viruses are exposed to the sanitizer. Bacteria require prolonged exposure to antibiotics to develop resistance. Hand sanitizers contain no antibiotics. Even if the microbes develop resistance to the alcohols in hand sanitizers, they will remain susceptible to antibiotics.
Controlled studies concluded hand sanitizers do not contribute to antibacterial resistance. In their collective review, Kampf and colleagues found no reports of antibiotic resistance related to alcohol-based hand sanitizers. In an earlier study E.C. Cole and his co-authors examined whether use of antibacterial cleansers resulted in increased resistance. None of the bacterial strains tested demonstrated antibiotic resistance, nor did the strains develop resistance to the cleansers.
Hand sanitizers are designed to be used without water and require no rinsing. Select a sanitizer with at least 60 percent alcohol for maximum effectiveness. Use enough of the product so that your hands are completely moistened and rub your hands together quickly to dry the sanitizer. Opt for soap and water if your hands are visibly dirty.
Effective Hand Washing
Wash your hands frequently to avoid infection. Wet you hands, lather well with soap and rub your hands together for at least 20 seconds. Rinse well and turn off the faucet with a paper towel or your wrist to avoid recontamination. Always wash your hands before and after preparing food or eating, after touching a sick or injured person or cleaning a wound, after coughing or sneezing and after using the restroom or changing a diaper. Remember to wash your hands before touching your face or inserting or removing contact lenses. Premoistened towelettes are useful but are less effective than alcohol-based hand sanitizers or soap and water.