Advisability of hand santiziers

I’ve heard that products such as antibacterial soaps, etc., may be bad because it prevents us from developing immunity to common bacteria.

In this age of SARS, how effective and healthy and advisable is the ample use of hand sanitizers?

I know the CDC recommends people to wash their hands often, since SARS is transmitted like the common cold. But would I be better off with a nice, big bottle of hand sanitizer? Will that help me not catch illnesses (not just SARS)?

We appreciate your kind enlightenment.

WRS

I try to avoid the use of anti-bacterial soaps (very difficult), and the hand sanitizers, because I believe that there is evidence that the bacteria, develop a resistence to those anti-bacterials and anti-biotics, in general, and that this is not a good thing.

I could be wrong, of course, but I don’t see too much reason to doubt what I have read. I do, of course, wash my hands when it would seem to be beneficial to do so.

Bob

An antibacterial soap will not make much of difference against SARS over a regular soap, as SARS has been identified as a virus.

(Unless of course, SARS uses some kind of bacteria to reproduce parasitically (I don’t happen to know which cells SARS uses), in which case antibacterial soap might help slow the spread of SARS until the bacteria developed immunity to the soap; see below)

There is a great deal of concern over antibacterial products because an antibiotic is never 100% effective. Some bacteria survive, and the ones who survive because some genetic variance granted them immunity to the antibiotic can pass this immunity on to later generations.

With each generation having more immune members, you eventually get to the point where the antibiotic is no longer effective. An antibiotic that kills these new, stronger bacteria may have more severe side effects than the older one.

With the advent of everyday use of antibacterial personal hygeine products, the rate at which bacteria become immune to various chemical agents is increasing dramatically. When I find a decent internet cite for this, I’ll post it here.

Hand sanitizers, in general, are a bit different than antibacterial soap. Hand sanitizers are simply alcohol in a gel matrix that allows it to be spread more easily, and be far less messy than liquid alcohol. However, it’s action is the same as rubbing alcohol. It is a non-targeted antibacterial agent. Which is to say, alcohol does not specifically target a component of the bacteria. It kills by dessication. This means that bacteria can not become resistant. So feel free to use hand sanitizers with abandon, or at least until they make your skin do dry that it peels from your body.

Antibacterial soaps use, in general, triclosan. This was at first believed to be non-target, but it turned out that this is not true. It is actually targeted to lipid synthesis via enoyl-acyl carrier protein reductase. This means that bacteria do gain resistance, and thus not quite as benign as originally believed.

Do you have a cite to back this up? The doctors I have worked for have told me that hand sanitizers DO act as “evolutionary pressure” on bacteria and contribute to their building resistance.

Pray, dear fellow, just where did you “hear” that antiseptic soaps can somehow interfere with the immune system? Was this from a reputable source or one of those crackpot “alternative medicine” screeds?

Perhaps the ideas of Dr. Stuart Levy, at Tufts University, have become distorted in the telling.

Tufts E-News

For more detail than you could believe, see the Food and Drug Administration/Center for Food Safety and Applied Nutrition literature review in:

“Evaluation of Risks Related to Microbiological Contamination of Ready-to-eat Food by Food Preparation Workers and the Effectiveness of Interventions to Minimize Those Risks” by JACK GUZEWICH, RS, MPH and MARIANNE P. ROSS, DVM, MPH, 1999.

http://vm.cfsan.fda.gov/~ear/rterisk.html

This analyses the efficacy of various methods of defeating bacterial, viral and other infections in the food industry.

On plain vs. antibacterial soaps, it says:

As for alcohol, and alcohol gel sanitisers, it is dubious about the latter:

It also finds Triclosan to be effective, and discusses hand-washing and hand-drying methods.

There has been some concern in the scientific community that, since we build up our immune system by exposing it to germs, our realitively clean way of living these days has affected our ability to develop antibodies. Research into this is still relatively new.

Reading the thread title, the first thing to jump to my mind was “telephone sanitizers”.

Hand sanitizers are probably about as useful.

I bought some bottles of these sanitizers to take on my trip to Japan, but that was mainly because it’s hard to find paper towels in Japanese bathrooms and I figured it’s a good way to make sure I have a way to keep my hands clean.

lissener, I’m not sure what you want me to cite, but re-reading my post I did say that alcohol was a desiccant, what I should have said that it is a desiccant/denaturing agent. Either way, it’s still not targeted antibacterial agent, thus a bacteria can not gain resistance sine it it the physics/chemistry of the cells that causes them to be killed by the alcohol, not a specific target. In other words, if one could use an H[sub]2[/sub]SO[sub]4[/sub] safely as a antibacterial agent, there wouldn’t be a whole lot the bacterial cell could do about. Sensitivity to low pH is not a genetic action. Neither is sensitivity to the denaturing/desiccating properties of alcohol. It dries so quickly that the osmotic pressure may cause the cells to burst. While at the same time, it is denaturing the proteins of the cellular membrane. It simply causes the protein and DNA to “unravel”. With a little weaseling, Infection Control Today says:

As for refusal’s assertion that gel/alcohol hand sanitizers are ineffective, this is untrue according to the the above cite, the CDC (Warning: pdf), and Infection Control and Hospital Epidemiology.

I read that the use of alcohol based sanitizers could cause a problem due to the fact that they dry out your skin, thus providing new routes for transmission of bacteria through cracked skin…No cite.

-Tcat

The scare about “overuse” of germ killers is bull. The biggest germ killer is running water, followed by soap, then plain alcohol swabs. They also are the first things recommended when you might be subject to infection. The main things is that the body can deal with all sorts of germs and viruses, but not too many at once. Does use of water mean mankind will no longer have germs that rinse off, but will find all germs are now waterproof? No.

Smasho, you are really confused with the rational behind the “scare about the ‘overuse’ of germ killers”.

The fear of antimicrobial resistance is legitimate, and warranted. Bacterial resistance to antibiotics is a huge issue in the health care field as you find with multiply resistant M, tuberculosis, and Methylcillin resistant Staph. aureus. The World Health Organization is so concerned about the trend they have a Global Strategy for Containment of Antimicrobial Resistance (Warning: pdf).

The problem is with the overuse of targeted antimicrobial agents. A targeted agent is on that specifically works against a particular genetic target of the organism. Targeted antibiotics like ampicillin, which worked like this:

Bactria overcome this by

This type of generically conferred resistance id dangerous indeed, as in this case any bacterium with the resistance isn’t eliminated by the original cycle of antibiotics, and it continues to grow, with each success generation being a clone of the original resistant bacterium. Now you have a resistant strain, and you need another cycle of antibiotics, which can not be beta-lactams.

The additional time needed for the second, third, fourth, treatments can be fatal.

And that Smasho, is why the scare isn’t bull.

Purely anecdotal inpuit here; a couple of years back, I switched to antibacterial washing up liquid; shortly afterward, I developed a hangnail so severe that it needed antibiotics (red streaks appeared in the surrounding skin), then another a week later; the next week, I had two on different fingers…and on it went.
Until I ran out of the washing up liquid and my wife bought another (non-antibacterial) brand - the hangnail problem went away.

Based on this one piece of flimsy evidence, I have (probably quite unacceptably) theorised that excessive use of antibacterial preparations on the skin might kill off your natural (benign) flora and leave (the resources on) your skin wide open for rapid colonisation by more virulent pathogenic organisms (should you be unlucky enough to contact them before the natural balance is re-established.

Mengetout’s comments brought up a question - are there any protective bacteria on our hands/skin surface?

And related to the whole issue of bacteria and resistance - I have read (not aware of any cites right now) that overusing antibiotics can be harmful for the same reason: it allows bacteria more opportunities to develop resistance.

So, soap, etc., can kill bacteria. What can kill viruses?

WRS

Um, doesn’t this prove my point, and disprove yours? The only antibacterial agent that won’t act as evolutionary pressure is the one that is 100% effective; “extremely low to almost non-existent” doesn’t cut it. The one bacterium left is the one that’s resistant, and the one that will reproduce more resistant bacteria.

Alcohol and antibiotics do not work the same way. If you shoot a group of people with a machine gun, those that survive will not be resistant to future gunshots, no matter how much the evolutionary pressure.