Since the uptake of Alcohol Based Hand Rubs for one of the key aspects of infection prevention and control, hand hygiene, recommendations for it's use has come from such influential bodies such as the WHO and CDC.
The CDC last reviewed its recommendations as far back as 2002. Since that date the use of ABHR's has unquestionably had an impact on infection control and infection rates, however with the experience of use over this time questions are beginning to be raised over the use of ABHR's.
The following study is one of many that surely should stimulate a review of both the recommendations made by both bodies, especially as there are a number of excellent alternatives now available which in 2002 was not the case.
Edwards, Patel and Wareham had a study published in The Journal of Medical Microbiology as long ago as 2007. "Low concentrations of commercial alcohol hand rubs facilitate growth of secretions of extracellular proteins by multidrug-resitant strains of Acinetobacter baumannii"
Just one small section of this in-depth study raises significant questions, "As ABHR's are extensively used in health care settings, the authors set out to determine whether the hand rubs could also influence the growth of prevalent multidrug-resistant strains circulating in UK hospitals. A significant increase in growth was observed"!!!
During the study commercially available ABHR's were used, Skinman, Softalind, Spirigel and Purell.
It makes fascinating reading, but more importantly it strengthens the argument along with many other factors, that it is time for the CDC and WHO to make an unbiased review of their recommendations.