When it comes to keeping clean, old fashioned soap and water may be best

Oct 19 2005

Over the last decade the popularity of soaps and cleaning products claiming to have anti-bacterial properties has mushroomed as consumers are persuaded, by clever marketing, that they offer a defense against household illnesses.

It is a contentious issue and many believe that a number of the products, particularly those that use synthetic chemicals rather than alcohol or bleach, may in fact increase the risk of infection by creating germs that are resistant to antibacterials as well as antibiotics.

Many experts contend that antibacterials are no more effective than regular soap in reducing infections and illnesses.

Unlike anti-bacterial products, regular household soap helps separate bacteria from the skin so they wash down the drain or attach to the hand towel when hands are dried.

Anti-bacterial soap kills the bacteria outright.

As expected manufacturers disagree with many of the critics' claims but both camps can quote studies they say support their viewpoint.

Now it seems a Food and Drug Administration panel of independent experts will debate these concerns in a public hearing.

The Nonprescription Drugs Advisory Committee will consider whether there is evidence that these products pose the long-term hazards, the critics contend.

The committee can then make recommendations on the sales and labeling of these products to the FDA, which ultimately has the authority to restrict availability of such soaps and related items.

However the FDA briefing documents available on the Internet, prior to the meeting, do not indicate that such a ruling is imminent.

Dr. Stuart Levy, president of the Alliance for the Prudent Use of Antibiotics, and a professor of medicine and molecular biology at Tufts University School of Medicine, says such products should be banned for use in healthy households.

He says, they should be used where they are needed, in hospitals and in homes with very sick people who are at greater risk if they get a bacterial infection.

Otherwise, he says there is the risk of changing the kinds of bacteria we confront every day in the home.

Apparently the small percentage of bacteria that survive a brush with the antibacterial product may develop resistance to it, and furthermore, he says, some surviving bacteria may have an improved ability to pump out all threatening substances, including antibiotics used to cure infections.

Those survivors may pass that mutation to their offspring, and the adaptation can come to dominate an entire population of bacteria, creating a resistance.

While Levy says that has happened in lab studies, there's no firm evidence it's happening in households.

Meanwhile Brian Sansoni, spokesman for an industry group, the Soap and Detergent Association, says studies have found no link between the real-world use of anti-bacterial products and bacterial resistance.

He maintains the products are proven to provide a preventive benefit for their users.

In a recent study published by the Centers for Disease Control, in which scientists, including Levy, observed the development of bacteria in 224 households for a year, no significant increase was seen in resistant bacteria in houses using anti-bacterial instead of regular soap, but nor did it show that anti-bacterial soap led to healthier homes than regular soap.

Further studies were recommended, saying the effect could take place over a longer term.

Only last month, the FDA began enforcing the first U.S. ban of a veterinary antibiotic because of concerns it could lead to antibiotic-resistant bacteria in humans.

Other issues to be considered by FDA panelists include whether the synthetic chemicals in some soaps pose a hazard in the environment after they wash down the drain and through wastewater systems.

They will also look at whether the use of antibacterials in homes may in fact leave those homes too clean for young children, who may need some exposure to the bacterial world to develop a strong immune system.

This controversial theory, called the "Hygiene Hypothesis", suggests that growing up in a too-clean environment may cause a person to develop asthma and serious allergies later in life.