Soap and water beats antibacterial agents

Your Health: Soap and water beats antibacterial agents
Rallie McAllister, M.D., M.P.H.
These days, you can find antibacterial agents in just about every consumer product imaginable. We slather antibacterial soaps and lotions on our bodies, we spray antibacterial cleansers on our bathroom fixtures and kitchen appliances, and we suds our clothes with antibacterial laundry detergents.

It might seem like the right thing to do, but in the war on germs, the use of antibacterial products may be doing more harm than good. Last fall, a U.S. Food and Drug Administration (FDA) advisory committee announced that using antibacterial products doesn't reduce the risk of illness any better than washing up with plain old soap and water.

According to Stuart Levy, M.D., a professor of medicine at Tufts University in Boston, "There are a lot of myths about antibacterial agents, but there is no scientific evidence to suggest that these types of products offer any health benefit." Levy, who served as an expert witness for the FDA panel, is the author of "The Antibiotic Paradox: How the Misuse of Antibiotics Destroys Their Curative Powers," (Perseus Books, 2002).

The experts testifying before the FDA committee reported that there is no proven correlation between the use of antiseptic hand washes and a reduction in the rate of illness in homes, schools, or day care centers. Of concern, said Levy, is the possibility that widespread use of common antibacterial products may promote the development of drug-resistant bacteria.

The active ingredients in most antibacterial soaps, detergents, and cleansers are triclosan and triclocarban, chemicals that kill germs by interfering with specific processes in the life cycle of the bacteria. "The problem with these antibacterial agents," said Levy, "is that they leave traces of chemical residues behind."

While the triclosan and triclocarban in antiseptic agents may kill susceptible bacteria on the spot, the bacteria that are not killed can undergo mutations that allow them to thrive in the presence of these chemicals. "If you use these products in your home over the years, it will likely lead to the build-up of a group of dominant bacteria that are resistant to these agents."

It is conceivable that this group of dominant bacteria might also be resistant to many types of antibiotics, rendering the drugs ineffective in the treatment of many infectious diseases. To avoid the creation of bacterial super-bugs, Levy and other experts feel that it is important to limit the indiscriminant use of antibacterial agents.

"We need to save these agents for situations in which they are absolutely necessary: in hospitals where patients are very sick and are more vulnerable to infection," said Levy. "It's not that we don't need surface antibacterial agents at all, it's just that we don't need them in consumer products."

While many experts are concerned about the direct health risk to humans, others are worried about the impact of triclosan and triclocarban accumulation in the environment. After finding triclocarban in surface water samples in Baltimore, a group of researchers at John Hopkins University suggested that the chemical may be an important contaminant of U.S. water sources.

When it comes to protecting yourself from disease-causing germs in the home, Levy emphasized that good hygiene is most important. "Wash your hands with soap and water before you eat and after using the restroom," he recommended.

Research has shown that hand-washing with soap and water not only removes bacteria from the skin, it also reduces the likelihood of infection. Soap works by trapping dirt and bacteria in fatty acids, so that water can wash them away.

If soap and water aren't immediately available, an alcohol-based hand sanitizer is an acceptable alternative to hand-washing. Studies have shown that while alcohol-based hand sanitizers can kill bacteria effectively, the use of these products has not been associated with bacterial resistance.

"In the kitchen, it's important to clean countertops after preparing meats," Levy advised. "Prepare salads and other foods on a separate surface so they don't get contaminated with the bacteria from animal products."

Instead of using home cleaning solutions containing antibacterial chemical agents, Levy recommends using those with bleach, alcohol, or hydrogen peroxide, which don't leave a residue. "These chemicals do a good job of killing bacteria, and because they evaporate rapidly, bacteria don't get the chance to build resistance to them," he noted.

The FDA has not yet acted on the recommendations offered by Levy and other members of the advisory panel. The organization is scheduled to conduct its final review of antibacterial products by 2007.

========

Rallie McAllister, M.D., M.P.H., is a family physician in Kingsport, Tenn., and author of "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her Web site is http://www.rallieonhealth.com. To find out more about Rallie McAllister, M.D., and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com.

Copyright 2006 Creators Syndicate Inc