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Comparison of the efficacy and drying times of liquid, gel and foam formats of alcohol-based hand rubs

Published:September 30, 2017DOI:https://doi.org/10.1016/j.jhin.2017.09.024

      Summary

      Background

      Hand rubs containing alcohols such as isopropanol (IPA) or ethanol (EtOH) are widely used for hygienic hand disinfection, and are presented in different formats (i.e. liquid, gel or foam).

      Aim

      To determine if there is any difference in efficacy between these two active ingredients in the three formats. In addition, an assessment of the drying time was undertaken. Two non-commercial, ‘standard’ formulations were tested in each format: one containing 60% IPA, and the other containing 80% EtOH.

      Methods

      EN 1500 tests were performed with 20 volunteers to assess efficacy. The reference product was 2 x 3 mL of 60% IPA for 60 s, as described in EN 1500 (2013). The test products were 3 mL of liquid, gel or foam format; one full EN 1500 test was performed for each formulation (60% IPA and 80% EtOH). To assess drying time, two different volumes (1.5 and 3.0 mL) of the test formulations in liquid, gel or foam format were applied to the hands of 15 volunteers. Volunteers self-reported when their hands were dry; at the end of the test, the volunteers were asked to rate the time taken to dry on a three-point scale (too short, OK, too long).

      Findings

      This study found no difference in antibacterial efficacy attributable to formulation or format for the two ‘standard’ ABHR formulations, as assessed by EN 1500. When measured objectively, the EtOH-based formulations dried more rapidly than the IPA-based formulations, and for both formulations, gels took longer to dry than other formats. User perception of drying time broadly agreed with objective measurement.

      Conclusion

      Given that there was no difference in efficacy and only moderate difference in drying time, it is proposed that ABHR in liquid, foam or gel format may be appropriate, provided that the specific product passes the required efficacy and safety standards.

      Keywords

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      References

        • World Health Organization
        WHO guidelines on hand hygiene in health care.
        WHO, Geneva2009 (Available at:) ([last accessed September 2017])
        • Loveday H.P.
        • Wilson J.A.
        • Pratt R.J.
        • Golsorkhi M.
        • Tingle A.
        • Bak A.
        • et al.
        Epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England.
        J Hosp Infect. 2014; 86: S1-S70
        • Rotter M.L.
        Hygienic hand disinfection.
        Infect Control. 1984; 5: 18-22
        • Pittet D.
        • Hugonnet S.
        • Harbarth S.
        • Mourouga P.
        Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme.
        Lancet. 2000; 356: 1307-1312
        • Kramer A.
        • Rudolph P.
        • Kampf G.
        • Pittet D.
        Limited efficacy of alcohol-based hand gels.
        Lancet. 2002; 359: 1489-1490
        • Kampf G.
        • Hofer M.
        • Wendt C.
        Efficacy of hand disinfectants against vancomycin-resistant enterococci in vitro.
        J Hosp Infect. 1999; 42: 143-150
        • Dharan S.
        • Hugonnet S.
        • Sax H.
        • Pittet D.
        Comparison of waterless hand antisepsis agents at short application times: raising the flag of concern.
        Infect Control Hosp Epidemiol. 2003; 24: 160-164
        • Kampf G.
        • Marschall S.
        • Eggerstedt S.
        • Ostermeyer C.
        Efficacy of ethanol-based hand foams using clinically relevant amounts: a cross-over controlled study among healthy volunteers.
        BMC Infect Dis. 2010; 10: 78
        • Macinga D.
        • Shumaker D.
        • Werner H.
        • Edmonds S.
        • Leslie R.
        • Parker A.
        • et al.
        The relative influences of product volume, delivery format and alcohol concentration on dry-time and efficacy of alcohol-based hand rubs.
        BMC Infect Dis. 2014; 14: 511
        • BS EN 1500
        Chemical disinfectants and antiseptics. Hygienic handrub. Test method and requirements (phase 2/step 2).
        2013
        • Venables W.N.
        • Ripley B.D.
        Modern applied statistics with S.
        4th ed. Springer, New York2002
        • Hothorn T.
        • Bretz F.
        • Westfall P.
        Simultaneous inference in general parametric models.
        Biometr J. 2008; 50: 346-363
        • Core Team R.
        R: a language and environment for statistical computing.
        R Foundation for Statistical Computing, Vienna2017 (Available at:)
        https://www.R-project.org/
        Date accessed: August 1, 2017
        • Wilkinson M.A.C.
        • Ormandy K.
        • Bradley C.R.
        • Fraise A.P.
        • Hines J.
        Dose considerations for alcohol-based hand rubs.
        J Hosp Infect. 2017; 95: 175-182