NEW YORK (Reuters Health) - Consumer products such as soaps and lotions often
contain germ-killing antimicrobials, but there is scant evidence they are
helpful in preventing infections, according to an American Medical Association
(AMA) committee.
What's more, they may actually be harmful in terms of promoting bacterial
resistance to germ-killers, according to a report from the AMA's Council on
Scientific Affairs published in the August issue of the journal Archives of
Dermatology.
Indiscriminate, widespread use of antimicrobial products is discouraged by
the medical community because it is believed to promote the growth of bacteria
resistant to chemicals used as hospital disinfectants.
Still, the use of antimicrobial-laden products, such as disinfecting hand
soaps and lotions, have skyrocketed in recent decades. Indeed, 45% of consumer
soaps contain an antimicrobial, even though there is no proof the products can
prevent infections better than regular soap, the report indicates.
In the study, Dr. Litjen Tan and colleagues reviewed scientific papers
published between 1966 and 2001 in an effort to learn if antimicrobial consumer
products may be a "significant source of antimicrobial resistance."
The authors report that "a growing number of studies" suggest that bacteria
are gaining resistance to the antimicrobials used in these products. It is even
possible that bacteria that become resistant to such antimicrobials may also be
harder to treat with therapeutic antibiotics, but more study is needed to
determine if this is true, Tan and colleagues said.
"Considering the available data and the critical nature of the antibiotic
resistance problem, it is prudent to avoid the use of antimicrobial agents in
consumer products," they conclude.
While antimicrobial-containing soap and other products can help prevent the
spread of infection in hospitals, nursing homes and newborn nurseries, they are
used in a "dramatically different" way than the consumer products, the authors
point out.
"These same surface chemicals have been used effectively for several decades
in hospitals under stringent guidelines that require, among other precautions,
minutes--not seconds--of exposure," according to an editorial by Dr. Stuart Levy
of Tufts University School of Medicine in Boston, Massachusetts. A high
concentration of the chemicals is left on surfaces "long enough to do the
antimicrobial job required."
In the home, however, the products leave a residue on the skin, kitchen or
bathroom in a less-than-effective dose, setting up the "perfect condition for
the selection of microbes resistant to their action," Levy notes.
There is no "evidence that additional cleaning or disinfecting power is
needed (in the home) beyond that provided by normal cleansers, soap and water,"
Levy writes. "Instead the negative consequences stemming from the residues of
these compounds present an unacceptable risk to the household."
In 2000, the AMA urged the US Food and Drug Administration to closely monitor and possibly regulate the use of such substances
in private homes, a decision Levy said is a good one.
However, the manufacturers of such products feel differently. In a statement
to Reuters Health, the Cosmetic, Toiletry and Fragrance Association (CTFA) noted
that "antimicrobial products kill germs, and that is a benefit to consumers and
their families. Removing these products would deprive consumers of effective
hygiene products and would not help in eliminating antibiotic resistance."
The CTFA added that "the AMA should focus efforts on preventing misuse and
over-prescription of antibiotic medicines by doctors and their patients, factors
that are known to contribute to an increase in antibiotic resistance."
The Washington, DC-based CTFA is a trade association for the personal care
products industry.
