Overkill in the sink? Soaps: Antibacterial agents may be no better than a good scrubbing.


Antibacterial soap?

Isn't that what soap is supposed to do anyway, kill germs? That's what your mother always said. Do we really need antibacterial soaps (and household cleaners and sponges) the way all the marketers tell us?

Yes and no, area experts say.

Yes, if you have a recurrent skin infection or work in a neonatal intensive care unit or change the iguana's cage.

But do we really need it every day?

"At home, it doesn't make that much difference," says Robert J. Ancona, a pediatrician in private practice in the Village of Cross Keys who specializes in pediatric infectious diseases. He explains that all soaps work by removing the layer of grease and grime in which bacteria live. "The problem really is with the frequency of hand-washing, no matter what soap you're using. I prefer to reinforce the hand-washing; I don't care what soap you use."

His words are echoed by Polly Ristaino, infection-control coordinator for St. Joseph Medical Center in Towson. "Water and friction are what's most important in removing transient bacteria from your hands."

Her hospital follows the guidelines of the Association for Practitioners of Infection Control, which recommends using antibacterial soaps in neonatal intensive-care units, critical-care units and operating rooms. But throughout the rest of the hospital, regular soap will suffice.

Not to mention that antibacterial soap "definitely is harsher on your hands," Ristaino says. "In a hospital we ask people to wash their hands every five minutes; when you wash so much, it can make people's hands rough and cracked and red."

Janet Donohue, spokeswoman for the Soap and Detergent Association, explains that antibacterial soaps contain ingredients - the most common is triclosan - that actually kill the bacteria and leave a residue that helps keep bacteria from recurring. "It's a cleaner clean, if you will."

Could these soaps become like antibiotics - creating fiercer, more resistant bacteria?

The Food and Drug Administration, which regulates antibacterial soaps, has convened an advisory committee to address the soap question.

"The FDA is looking at this and reviewing the information and waiting on data at this point," says Susan Cruzan, a spokeswoman. Cruzan adds that all antibacterial ingredients in soap are awaiting further study, except for two classified as safe and effective: alcohol and iodine.

Ancona says antibacterial soaps work differently than antibiotics do; the chemical in the soap disrupts the bacteria cell wall; antibiotics bind to the surface of a cell, and interfere with the XTC cell's metabolic response. Because of that different mechanism, resistant bacteria generally are not a problem.

"However," he says, "you can't get rid of all of the germs. No matter what soap you're using, if you culture your hands five to 10 minutes after washing, you get something back." But he does recommend the antibacterial soap for patients with recurrent skin infections and says it helps to reduce bacteria colony counts.

Studies in institutional settings have shown that the soaps did reduce the level of bacteria on the skin, and Donohue suggests they might be particularly appropriate for parents who deal with dirty diapers.

But what's the verdict for your family with their grubby hands?

"People ask me all the time, 'Should I be using them?' and I say, 'No,'" says Ristaino. "They're not necessary and they cost more."

Pub date: 5/24/98

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