Infection prevention
Triclosan. Sounds like something that might be mentioned in a Marvel superhero movie. In reality, it’s much more prosaic.
Triclosan is a commonly used ingredient in antibacterial soap products. In December 2017, the U.S. Food and Drug Administration banned it as an active ingredient because of a lack of data provided on its safety and efficacy. Manufacturers have until December 2018 to reformulate their soap products or remove the triclosan-based products from the market.
“Healthcare facilities with excess inventory of triclosan-based soaps may deplete it after December 2018, or simply discard it”, says Megan DiGiorgio, MSN, RN, CIC, FAPIC, clinical manager, GOJO Industries.
Choosing a soap
“Some facilities are unaware of the type of soap they are using,” says DiGiorgio. “The focus of many hand hygiene programs is – rightly so – hand sanitizer, because it is the preferred method for cleaning hands that are not visibly soiled. Less attention has been given to soap in the past, so these changes are an opportunity to evaluate current products.”
Many healthcare facilities are unsure of whether to use an antimicrobial soap or a non-antimicrobial soap, and frequently wonder what is allowed in healthcare, she says.
Hand hygiene guidelines from the Centers for Disease Control and Prevention and the World Health Organization allow the use of either an antimicrobial or a non-antimicrobial soap, says DiGiorgio. Due to a lack of evidence demonstrating their clinical benefit (i.e., resulting reduction of infection rates), neither organization recommends one over the other. However, published studies of bacterial reduction on the hands demonstrate that alcohol-based hand rub is most efficacious, followed by antimicrobial soap, followed by non-antimicrobial soap as least efficacious.
A good way to approach the decision of whether to choose an antimicrobial or a non-antimicrobial soap is to consider risk reduction, says DiGiorgio. “The greatest risk reduction will be achieved by using an antimicrobial soap, which will result in a higher log reduction of bacteria on hands,” she says. “Non-antimicrobial soap will result in a lower log reduction of bacteria on hands and leave more bacteria behind, which could potentially mean pathogens are transmitted to patients.”
Other factors that should be considered when selecting a soap include:
- Does the product meet FDA efficacy requirements?
- Is it gentle to healthcare workers’ skin with repeated use? Do healthcare workers like aspects of the soap, such as its lather, scent, and rinsing factor?
Additional resources: “5 Things to Know About Triclosan,” https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm205999.htm; and a free whitepaper on the science of soap from GOJO Industries, at http://gojo.com/HealthcareSolutions.