Abstract
BackgroundGuidelines for hand hygiene recommend the use of alcohol-based hand rubs containing humectants in order to improve dermal tolerance. However, the bactericidal efficacy of pre-surgical hand rubs is negatively affected by the WHO-recommended humectant glycerol, especially the 3-h efficacy. The aim of this study was to investigate whether replacing glycerol as humectant increases the bactericidal efficacy of surgical hand rubs based on isopropanol (75%, wt/wt).Material and methodsThe efficacy of 3 and 5 min applications of a modified WHO II-formulation (containing lower glycerol concentrations) and the TPH 5766 hand rub which contains a new humectant (containing ethylhexylglycerin, dexpanthenol and a fatty alcohol) were compared to the European Norm 12,791 reference (n-propanol, 60%, vol/vol) immediately following and 3 h after application.ResultsImmediately after application both isopropanol-based surgical rubs approximated the performance of the reference. The 3-h effect of the modified WHO II-formulation was found to be less efficacious than the EN 12791, showing a 30% decrease in log10 reduction values. The 3-h post application effect for the TPH 5766 hand rub was found to not be different from EN 12791.ConclusionBased on our data, the bactericidal efficacy of isopropanol-based surgical hand rubs can best be obtained if glycerol is not used in the formulation. Unlike glycerol, a humectant comprised of ethylhexylglycerin, dexpanthenol and a fatty alcohol was found not to decrease hand rub effectiveness. Further investigation of the bactericidal efficacy of other humectants is necessary and may prove useful.
Highlights
Guidelines for hand hygiene recommend the use of alcohol-based hand rubs containing humectants in order to improve dermal tolerance
Immediately after application both isopropanol-based surgical rubs approximated the performance of the reference
Based on our data, the bactericidal efficacy of isopropanol-based surgical hand rubs can best be obtained if glycerol is not used in the formulation
Summary
Guidelines for hand hygiene recommend the use of alcohol-based hand rubs containing humectants in order to improve dermal tolerance. The aim of this study was to investigate whether replacing glycerol as humectant increases the bactericidal efficacy of surgical hand rubs based on isopropanol (75%, wt/wt). 12,791 [4], the in vivo laboratory assay for testing the bactericidal efficacy of pre-surgical hand preparations. Increasing their alcohol concentrations by 5% and halving the glycerol concentration brought both WHO formulations in compliance with EN 12791 [5]. The aim was to investigate whether reduction or replacement of glycerol by another humectant leads to an acceptable efficacy as pre-surgical hand rub according to EN 12791, with emphasis on its effectiveness 3-h after application
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