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Plain Soap as Good as Antibacterial
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Researchers Say Regular Soap Kills Germs as Well as Antibacterial Soap
By Salynn Boyles
Reviewed by Louise Chang, MD
Aug. 17, 2007 -- Antibacterial soaps are no more effective than plain soap and water for killing disease-causing germs, but the jury is still out on whether they promote antibiotic resistance in users, a newly published research analysis shows.
Researchers from the University of Michigan School of Public Health reviewed 27 studies examining the safety and effectiveness of antibacterial products containing the active ingredient triclosan.
That includes most commercially available soaps, detergents and other products with the word 'antibacterial' on their labels, with the notable exception of alcohol-based hand gels.
Soaps containing triclosan at concentrations commonly seen in products sold to the public were found to be no better for killing bacteria and preventing infectious illness than soaps that did not contain triclosan.
"Antibacterial soaps do not provide a benefit above and beyond plain soaps for generally healthy people living in the community," researcher Allison Aiello, PhD, tells WebMD.
"Washing your hands is extremely important for preventing the spread of infectious illness, especially at critical points like after using the toilet, changing the baby, or handling raw foods. But consumers can't assume that antibacterial soaps are better for this than other soaps."
Antibacterial Soap, Antibiotic Resistance
Along with University of Michigan colleagues Elaine Larson, RN, PhD, and Stuart Levy, MD, Aiello has conducted some of the largest and most rigorously designed studies examining the safety and effectiveness of antibacterial products.
Studies in their own laboratory first showed that triclosan can cause some bacteria to become resistant to widely used antibiotics like amoxicillin, but this has not been shown outside the lab.
In another of their studies, 238 families were told to either use triclosan-containing cleaning and hygiene products for a year or similar products without the antibacterial agent. Skin testing conducted before, during, and after the intervention suggested that both cleansing regimens were equally effective for killing germs.
There was also no evidence of an increase in antibiotic-resistant bacteria on the hands of people who washed with the antibacterial products.
A spokesman for the soap industry tells WebMD that no evidence exists outside the laboratory linking the use of antibacterial soaps and cleansers to the promotion of antibiotic-resistant superbugs.
"It is egregious to continually hype the hypothesis that these products are contributing to antibiotic resistance," Brian Sansoni of the Soap and Detergent Association (SDA) tells WebMD. "These researchers keep raising the specter of what could happen, but it is a ghost story without a ghost."
FDA: Antibacterial Soaps Not Better
Sansoni called the review "predictable repackaging of old studies and old opinions," adding that the issue of whether antibacterial soaps and cleansers promote antibiotic resistance has been put to rest by "study after study."
Aiello disagrees. While antibiotic resistance is routinely tracked in hospitals and other health care settings, tracking resistance trends in the community remains a huge challenge, she says.
"These [community-based] studies are very hard to do," she tells WebMD. "We haven't been able to study this in the way we would like, and I don't know if we will be able to in the future."
An FDA advisory panel considered the question of the effectiveness of antibacterial products in the fall of 2005; the panel overwhelmingly concluded that there was no evidence proving that antibacterial soaps were more effective than regular soaps for preventing infection.
There was talk at the time of restricting the labeling or advertising of new antibacterial products, but the agency has taken no formal action.
SOURCES: Aiello, A.E. Clinical Infectious Diseases, August 2007; online edition. Allison Aiello, PhD, assistant professor of epidemiology, Center for Society Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor. Brian Sansoni, spokesman, Soap and Detergent Association. WebMD Health News: "FDA Panel: No Advantage to Antibacterial Soaps."
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