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.
