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Antibacterial Products Don't Cut Infection Risk at Home

Study adds they may have some value in large settings, such as a school

MONDAY, March 1, 2004 (HealthDayNews) -- Heavily marketed antibacterial products don't reduce the risk for infectious disease symptoms in ordinary households, a new study claims.

"For years we've been using antibacterial products and everybody assumes a health benefit," says study author Elaine Larson, a professor of pharmaceutical and therapeutic research at Columbia University School of Nursing in New York City. "Nobody has really looked at whether it actually has an effect on infectious disease."

"If you use non-antibacterial-containing soaps in the formulations that were described in this article and you use them appropriately, you're no worse off than if you use antibacterial soaps," says Dr. J. Todd Weber, co-author of an editorial appearing with the study in the March 2 issue of the Annals of Internal Medicine.

It's almost impossible to find non-antibacterial products in today's supermarkets and grocery stores. "Over 70 percent of the liquid soap you can buy now is labeled antibacterial," Larson says.

Larson and her colleagues studied 224 households in New York City containing 1,178 people. Each household had at least one child in preschool. The households were randomly assigned to use cleaning, laundry and hand washing products that contained antibacterial ingredients, or identical-looking products that did not have antibacterial ingredients. Household members were monitored for disease symptoms by phone and by home visits.

The study, which used four full-time staff members just to make home visits, was funded by the U.S. government.

At the end of 48 weeks, there was essentially no difference between the two groups in the seven infectious disease symptoms surveyed, including runny nose, cough, sore throat, vomiting and diarrhea. The researchers did not actually perform cultures to verify an infection, but they did have a physician pay a house visit for the first 100 people who reported signs of an infection.

"We were able to verify symptoms in almost every case," Larson says. "We feel pretty good that even though we used self-report that we have accurate information."

One explanation for the findings is that the infections that occurred might have been viral and not bacterial, Larson says. Antibacterial products aren't supposed to have an effect on viruses. On the other hand, there may be a popular perception that these products will combat any infection.

"When I buy an antibacterial product, in my mind, I'm thinking this is going to reduce my risk of infections," Larson says. "Consumers don't think about the fact that most of the infections healthy people get are cold, flu and diarrhea caused by viruses.

It's also possible the products can prevent bacterial infections but, because such infections are relatively rare in healthy people, that effect was not observed in this study.

The Soap and Detergent Association, an industry group, disputes the finding.

"An extensive search of the scientific and marketing literature using state-of-the-art electronic search engines, as well as more traditional means, identified a substantial body of evidence demonstrating the benefits of topical antimicrobial products," the association says in a statement. "Based on the studies identified above, the Industry Coalition believes the reduction of the normal flora, both transient and resident, is sufficiently supported to be considered a benefit."

The products may have value in other settings, health experts add.

"It's possible [these products have a role] in different settings with different modes of transmission and different likelihoods of transmission," says Weber, an antimicrobial resistance expert who is assistant to the director of the National Center for Infectious Diseases. "It's unproved now, but that certainly would be something for research."

Such settings might include health-care centers and large institutions such as schools and correctional facilities.

The study also didn't deal with the issue of bacterial resistance. There is widespread concern among health experts that these products can contribute to bacterial resistance, although this has not yet been proved in people.

Some experts feel that even the possibility of resistance should act as a deterrent. "If there's no difference between two products and one has a putative link to resistance that could affect human health and the other doesn't, that might tip the balance," Weber says.

So, do we have any defense against germs?

Larson advises those who are looking for "a big kill," should go for the alcohol hand rinses. "If you want to kill a lot of germs on your hands quickly, the best thing is to use one of the alcohol hand rinses because they work much faster than soap and they kill bacteria and viruses much more," Larson says. "You don't have to have a paper towel. You don't have to have a sink. You can carry them in the car and on the airplane. There's also no danger of resistance."

The editorial writers have an even lower-tech and more cost-effective suggestion: Cover your mouth and nose when coughing or sneezing and wash your hands frequently.

More information

For more on bacterial resistance, visit the Alliance for the Prudent Use of Antibiotics. The National Center for Infectious Diseases has more on hand washing and staying healthy.

SOURCES: Elaine Larson, R.N., Ph.D., professor, pharmaceutical and therapeutic research, and associate dean, research, Columbia University School of Nursing, New York City; J. Todd Weber, M.D., assistant to the director, National Center for Infectious Diseases, Atlanta; March 2, 2004, Annals of Internal Medicine
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