In 2002 the CDC in the US were very forward thinking in the development of Hand Hygiene Guidelines, it certainly has been one of the foundations for the increased knowledge for the need of strict hand hygiene protocols and the positive impact that has on reducing HCAI's.
Within that guideline they recommended the use of Alcohol Based Hand Rubs (ABHR's), the only product readily available at that time.
In the following nine years however there have been major steps forward with other products such as non alcohol based hand rubs and further information about ABHR's which should stimulate a long awaited unbiased review of all the products available, allowing new recommendations to be put in place.
Perhaps this is being done out of the public domain. In the fast changing world of healthcare protocols and procedures it seems that nine years for an updated recommendation on such a critical area such as Hand Hygiene and the impact on HCAI's is a very long time.