PUBLISHED: 10:45 AM on Wednesday, January 18, 2006
Antibacterial soap: Too much of a good thing?
Purchasing liquid or bar soaps with the word "antibacterial" emblazoned on the package may make consumers worried about flu season feel better. But scientific research has shown that those products give no added benefits over using plain soap and water.

More than 75 percent of liquid soaps and 30 percent of bar soaps on the market today contain an antibacterial agent.

Correct washing

• Wet your hands and apply liquid or clean bar soap. Place the bar soap on a rack and allow it to drain.

• Rub your hands vigorously together and scrub all surfaces.

• Continue for 10-15 seconds (children can sing one verse of "Happy Birthday.") It is soap combined with scrubbing action that dislodges and removes germs.

• Rinse well and dry your hands.

Source: Centers for Disease Control

Elaine Larson, a professor of pharmaceutical and therapeutic research at Columbia University School of Nursing in New York City, has studied the use of antibacterial soaps, and she is the first to say there is no evidence that they are harmful. But the bacteria-fighting products haven't been shown to be helpful in a normal residential situation.

"Most of the research that's been done so far show that they don't make any difference in terms of preventing infection except possibly in people who have skin infections," Larson said.

Kathy Kilmartin, infection control professional at Stormont-Vail HealthCare, said regular soap and water are the best things for cleaning hands.

"It's not as harsh," she said. "The most important thing with hand-washing is the friction."

While there is general agreement in the medical community that antibacterial cleaners aren't particularly useful except in households where someone has low immunity or is seriously ill, there is much disagreement about other possible repercussions of the products.

Some organizations, such as the Alliance for the Prudent Use of Antibiotics, are concerned that the growing use of antibacterial products is adding to the international health concerns about antibiotic resistance. Medical research has found a disturbing number of bacteria that have become antibiotic resistant, what have been called "superbugs."

"Significant change has occurred with the large-scale human uses of antibiotics because these substances kill off antibiotic-susceptible bacteria, and thus create favorable environments for the overgrowth of resistant strains," according to APUA's Web site. "As antibiotics become more widely used, resistant strains of both harmful and harmless bacteria are replacing antibiotic-susceptible bacteria."

"The main concern is whether using an antibacterial soap might have some cross-resistance with antibiotics," Larson said. "That's occurred in labs, but it's not been shown in humans at all."

In fact, one researcher, Dr. Eugene C. Cole from Brigham Young University, found that using antibacterial soaps doesn't contribute to antibiotic resistance in household bacteria.

"Antibiotic resistance continues to be a worldwide health concern," Cole said in a news release. "But our study indicates there isn't a relationship between this problem and antibacterial cleaning products used in the home."

An additional study co-authored by researchers from Tufts University, University of Michigan and Columbia University (Larson was a co-author), found basically the same information.

That study centered on the most common antibacterial agent in household substances, triclosan. In the 1990s, there was a nationwide scare focused on triclosan, saying that its extensive use could cause the emergence of supergerms. The study failed to show that, although it did say that longer-term studies (more than one year) should be done.

Rather than antibacterial products, Larson recommends the use of alcohol-type hand sanitizer, like Purell, when soap and water aren't available.

"Those actually are excellent," she said. "I recommend those when people are wanting to keep their hands clean but maybe they're at work or on an airplane or driving down the street and there's no sink or clean towel. They actually kill more germs than regular hand washing."