Revisiting the hand wipe versus gel rub debate: Is a higher-ethanol content hand wipe more effective than an ethanol gel rub?

• Published in: American journal of infection control Vol. 38; no. 9; pp. 678 - 682
• Main Authors: D’Antonio, Natalie N., MS, Rihs, John D., BS, Stout, Janet E., PhD, Yu, Victor L., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.11.2010; Elsevier; Mosby-Year Book, Inc
• Subjects: Administration, Topical; alcohol; Antibiotics. Antiinfectious agents. Antiparasitic agents; antimicrobial; Antimicrobial agents; Antiseptics; Biological and medical sciences; Colony Count, Microbial; Disease control; Disinfectants - administration & dosage; Disinfectants - pharmacology; Disinfection & disinfectants; Epidemiology. Vaccinations; Ethanol; Ethanol - administration & dosage; Ethanol - pharmacology; General aspects; Geobacillus stearothermophilus - drug effects; Hand Disinfection - methods; Hand hygiene; hand sanitizer; Hands; Humans; Infection Control; Infection Control - methods; Infectious Disease; Infectious diseases; Medical sciences; Pharmacology. Drug treatments; Serratia marcescens - drug effects; Soap; Spores, Bacterial - drug effects; waterless; alcohol; antimicrobial; Hand hygiene; hand sanitizer; waterless; Ethanol; Check; Alcohol; Hand; Antimicrobial agent; Prevention; Infection; Disinfecting agent; Comparative study; Hygiene
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2010.07.002

Background The Centers for Disease Control and Prevention’s guidelines for hand hygiene state that the use of alcohol-based hand wipes is not an effective substitute for the use of an alcohol-based hand rub or handwashing with an antimicrobial soap and water. The objective of this study was to determine whether a hand wipe with higher ethanol content (65.9%) is as effective as an ethanol hand rub or antimicrobial soap in removing bacteria and spores from hands. Methods In two separate experiments, the hands of 7 subjects were inoculated with a suspension of S erratia marcescens or Geobacillus stearothermophilus . Subjects washed with each of 3 different products: 65.9% ethanol hand wipes (Sani-Hands ALC), 62% ethanol gel rub (Purell), and antimicrobial soap containing 0.75% triclosan (Kindest Kare). Results A total of 56 observations were analyzed for S marcescens removal and 70 observations were analyzed for G stearothermophilus removal. The rank order of product efficacy for both bacteria and spore removal was antibacterial soap > 65.9% ethanol hand wipes >62% ethanol hand rub. Mean S marcescens log reductions (±SD) for the 65.9% ethanol alcohol wipe, 62% ethanol alcohol rub, and antimicrobial foam soap were 3.44 ± 0.847, 2.32 ± 1.065, and 4.44 ± 1.018, respectively ( P < .001). Mean G stearothermophilus  log reductions for the 65.9% ethanol wipe, 62% ethanol rub, and antimicrobial foam soap were 0.51 ± 0.26, −0.8 ± 0.32 increase over baseline, and 1.72 ± 0.62, respectively ( P < .001). Conclusion The alcohol-based hand wipe containing 65.9% ethanol was significantly more effective than the 62% ethanol rub in reducing the number of viable bacteria and spores on the hands.