| FAQ - Hand Hygiene - 2014
Is there a list of FDA approved for healthcare settings of hand sanitizers/soaps? I have a few providers that claim they can not use any alcohol based products do to sensitivity, and this sensitivity applies to anti-microbial soaps as well. Any suggestions?
In general, the 2003 CDC guidelines for infection control in dentistry states as follows regarding hand hygiene:
The preferred method for hand hygiene depends on the type of procedure, the degree of contamination, and the desired persistence of antimicrobial action on the skin (Table 2). For routine dental examinations and nonsurgical procedures, handwashing and hand antisepsis is achieved by using either a plain or antimicrobial soap and water. If the hands are not visibly soiled, an alcohol-based hand rub is adequate.
The purpose of surgical hand antisepsis is to eliminate transient flora and reduce resident flora for the duration of a procedure to prevent introduction of organisms in the operative wound, if gloves become punctured or torn. Skin bacteria can rapidly multiply under surgical gloves if hands are washed with soap that is not antimicrobial (127,128). Thus, an antimicrobial soap or alcohol hand rub with persistent activity should be used before surgical procedures (129–131).
Agents used for surgical hand antisepsis should substantially reduce microorganisms on intact skin, contain a nonirritating antimicrobial preparation, have a broad spectrum of activity, be fast-acting, and have a persistent effect (121,132–135). Persistence (i.e., extended antimicrobial activity that prevents or inhibits survival of microorganisms after the product is applied) is critical because microorganisms can colonize on hands in the moist environment underneath gloves (122).
Alcohol hand rubs are rapidly germicidal when applied to the skin but should include such antiseptics as chlorhexidine, quaternary ammonium compounds, octenidine, or triclosan to achieve persistent activity (130). Factors that can influence the effectiveness of the surgical hand antisepsis in addition to the choice of antiseptic agent include duration and technique of scrubbing, as well as condition of the hands, and techniques used for drying and gloving. CDC’s 2002 guideline on hand hygiene in health-care settings provides more complete information (123).
Selection of Antiseptic Agents
Selecting the most appropriate antiseptic agent for hand hygiene requires consideration of multiple factors. Essential performance characteristics of a product (e.g., the spectrum and persistence of activity and whether or not the agent is fast acting) should be determined before selecting a product. Delivery system, cost per use, reliable vendor support and supply are also considerations. Because HCP acceptance is a major factor regarding compliance with recommended hand hygiene protocols (122,123,147,148), considering DHCP needs is critical and should include possible chemical allergies, skin integrity after repeated use, compatibility with lotions used, and offensive agent ingredients (e.g., scent). Discussing specific preparations or ingredients used for hand antisepsis is beyond the scope of this report. DHCP should choose from commercially available HCP handwashes when selecting agents for hand antisepsis or surgical hand antisepsis. 1
We are not aware of a specific list(s) that compiles all the FDA approved antibacterial hand soaps and hand sanitizers for use in healthcare settings. However, one can search the FDA website (http://www.fda.gov/) for specific products and manufacturers.
You may also wish to consider speaking to the manufacturer(s) of the product(s) being referenced to see if they have any further comments or suggestions.
Additionally, you may find some helpful information in these Google searches:
FDA approved hand soaps
FDA approved hand sanitizers
List of FDA approved hand soap
List of FDA approved hand sanitizers
1) Kohn WG, Collins AS, Cleveland JL, Harte JA, Eklund KJ, Malvitz DM, Centers for Disease Control and Prevention (CDC). Guidelines for infection control in dental health-care settings—2003. MMWR Recomm Rep 2003;52(RR-17):1-61. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm Accessed on January 14, 2014.
2) Google.com. Search for FDA approved hand soaps
https://www.google.com/#q=fda+approved+hand+soaps Accessed on January 14, 2014.
3) Google.com. Search for FDA approved hand sanitizers
https://www.google.com/#q=FDA+approved+hand+sanitizers Accessed on January 14, 2014.
4) Google.com. Search for List of FDA approved hand soap
https://www.google.com/#q=list+of+fda+approved+hand+soap Accessed on January 14, 2014.
5) Google.com. Search for List of FDA approved hand sanitizers
https://www.google.com/#q=list+of+fda+approved+hand+sanitizers Accessed on January 14, 2014.