Hand hygiene among health-care workers is a major priority to prevent the spread of infection in hospitals. Soap and water (used in the USA) and alcohol-based hand rub (commonly used in Europe) are the main methods for hand hygiene; hand rub is thought to be more effective as it causes less skin irritation, is quicker to administer, and can be used at the bedside. Gel formulations of alcohol-based hand rub have recently been introduced to counteract the drying effect of alcohol rinses in order to increase hand-hygiene compliance.
Didier Pittet from the University of Geneva, Switzerland, and colleagues from Germany investigated the antimicrobial efficacy of ten alcohol-based gels and four alcohol-based hand rinses in comparison to a reference disinfectant (2-propanol 60%); the reference disinfectant meets European requirements for antiseptic efficacy (known as EN 1500 requirements. None of the gel formulations, most of which were ethanol-based, were as effective as the reference disinfectant within 30 seconds of application; all of the hand rinses showed no significant difference in efficacy from the reference disinfectant.
Didier Pittet comments: “In hospitals where most health-care workers use alcohol-based solutions that already meet the EN 1500 requirements, the introduction of any of the tested gels would be a backward step and unnecessarily lower the hygiene standard. An increased risk of cross-transmission would certainly result because the application time in daily practice averages 8-15 seconds and is unlikely to exceed 30 seconds
The Lancet