Mother was right. Washing your hands is one of the best ways to fight germs. But do you really need an antibacterial soap to do the job? Some researchers say no, and they caution that antibacterial products may do more harm than good.
In the past few years, research says that antibacterial agents contained in soaps actually may kill off normal bacteria, creating an environment for resistant, mutated bacteria that are impervious to antibacterials, including antibiotics.
"These mutated bacteria get smart to antibacterial agents," says Eli Perencevich, M.D., a research fellow in infectious diseases at the Beth Israel Deaconess Medical Center in Boston.
By using antibacterial soaps over and over, more bacteria will become resistant to the products, Perencevich says. In that respect, antibacterial agents behave like antibiotics which, when overused, promote the spread of antibiotic resistance.
Look for the antibacterial label
Consumers should pay close attention to labeling when buying soap, Perencevich says, because an increasing number of products contain antibacterials.
"With so many of these products on the market, consumers may not even realize they are purchasing soaps that contain antibacterials," he says.
More than 75 percent of all liquid hand soaps and nearly 30 percent of bar soaps for sale nationally contain antibacterial agents, according to a study Perencevich co-authored. In a survey of national chain stores, regional stores and e-commerce sites, researchers found nearly half of all commercial soaps contain the antibacterial agents triclosan, or to a lesser extent, triclocarban.
"There has been no scientific data published to support the claim that adding these compounds to household products prevents infection," Perencevich says.
Antibacterial soaps also can be more drying than ordinary soaps. Some pediatricians even discourage using them on children because they can be too harsh on their skin.
Triclosan has been used as an antibacterial for many years. However, it only recently raised a red flag as researchers have learned how it acts on bacteria, says Stuart Levy, a professor of molecular biology and microbiology and director of the Center for Adaptation Genetics and Drug Resistance at Tufts University School of Medicine in Boston.
Researchers used to believe that triclosan killed bacteria in a broad-based manner, similar to alcohol and peroxide. What Levy and his colleagues found, in their study published in the journal Nature, was that triclosan, like an antibiotic, has a more targeted approach. Triclosan aims at a specific gene in E. coli bacteria so that it can't replicate. But Levy says the action actually may encourage bacteria to evolve into forms that are resistant to triclosan or other antibiotic agents.
Soap and detergent makers and members of the cosmetic industry say that products with triclosan have been used for more than 30 years without any evidence of bacterial resistance. "In fact, hospitals use antibacterial products every day to stop the spread of bacteria, including resistant bacteria," according to a question-and-answer fact sheet the Soap and Detergent Association has about antibacterial soaps on its Web site (www.sdahq.org).
However, Levy and Perencevich say antibacterials have caught on from hospitals to households and it is the magnitude of use that is cause for concern.
Will ordinary soap do the job?
Perencevich says washing with regular soap and warm water is still one of the best ways to fight germs.
Despite Americans' fastidiousness with germ control, at least a third have forgotten that piece of infection control advice. A recent survey conducted for the American Society of Microbiology found that while 95 percent of men and women surveyed say they wash their hands after using a public restroom, only 67 percent of people actually do wash before leaving the restroom.
"Handwashing is the simplest, most effective thing people can do to reduce the spread of infectious diseases," says Julie Gerberding, M.D., director of the Centers for Disease Control and Prevention (CDC).
The CDC says antibacterial soaps are not necessary. However, the agency deems handwashing so important in preventing the spread of infections that it actually offers these guidelines for how and when hands should be washed:
- Always use warm, running water and a mild, preferably liquid, soap. Antibacterial soaps may be used but are not required.
- Wet hands and apply a small amount (dime to quarter size) of liquid soap. Rub hands together vigorously until a soapy lather appears and continue for at least 15 seconds. Be sure to scrub between fingers, under fingernails, and around the tops and palms of the hands.
- Rinse hands under warm running water. Leave the water running while drying.
- Dry hands with a clean, disposable (or single use) towel. Turn the faucet off using the towel as a barrier between your hands and the faucet handle. Remember, dirty hands turned the faucet on.
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External Source
 | Centers for Disease Control and Prevention: Destinations
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This article was reviewed and updated June 2007.
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