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hand antiseptic; hand sanitzer (alcohol-based hand rub)

Alcohol-based antiseptic for hand hygiene. Also see hand hygiene. Indications: - hand hygiene, may be superior to handwashing for infection control if hands not visibly soiled - alcohol active ingredients (ethanol or isopropanol) in commercially available hand sanitizers, even when diluted to 30%, are effective in killing SARS-CoV-2 in vitro when used for >= 30 seconds [5] - may be of value in controlling spread of norovirus [6] Contraindications: - infection control associated with C difficile - does not eradicate C difficile spores [2] Procedure: - hands must be rubbed together vigorously, paying particular attention to the tips of the fingers, the thumbs, & the areas between the fingers, until the solution has evaporated & the hands are dry Complications: - ingestion & ocular exposures among children [3] - vomiting, oral irritation, cough, abdominal pain - coma, seizure, hypoglycemia, metabolic acidosis, respiratory depression (rare) - ocular exposures may result in conjunctivitis, conjunctival ischemia, corneal defects, superficial punctate keratopathy, blindnessin children [7] - no deaths [3] - hospital Enterococcus faecium becoming increasingly tolerant of alcohol-based hand sanitizers [4] - benzene detected in multiple hand sanitizers [8]

Related

handwashing

General

topical antiseptic hand hygiene

References

  1. Prescriber's Letter 14(8): 2007 Ingestion of Alcohol-based Hand Sanitizers Detail-Document#: 230810 (subscription needed) http://www.prescribersletter.com
  2. Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
  3. Santos C, Kieszak S, Wang A, Law R, Schier J, Wolkin A. Reported Adverse Health Effects in Children from Ingestion of Alcohol-Based Hand Sanitizers - United States, 2011-2014. MMWR Morb Mortal Wkly Rep 2017;66:223-226 https://www.cdc.gov/mmwr/volumes/66/wr/mm6608a5.htm
  4. Pidot SJ, Gao W, Buultjens AH et al Increasing tolerance of hospital Enterococcus faecium to handwash alcohols. Science Translational Medicine. Aug 1, 2018: 10(452):eaar6115 PMID: 30068573 http://stm.sciencemag.org/content/10/452/eaar6115
  5. Kratzel A, odt D, V'kovski P et al. Inactivation of severe acute respiratory syndrome coronavirus 2 by WHO-recommended hand rub formulations and alcohols. Emerg Infect Dis 2020 Apr 13; [e-pub] PMID: 32284092 Free Article https://wwwnc.cdc.gov/eid/article/26/7/20-0915_article
  6. Riddle MS, DuPont HL, Connor BA. ACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Acute Diarrheal Infections in Adults. Am J Gastroenterol. 2016 May;111(5):602-22. PMID: 27068718
  7. Yangzes S, Grewal S, Gailson T et al Hand Sanitizer-Induced Ocular Injury. A COVID-19 Hazard in Children. JAMA Ophthalmol. 2021;139(3):362-364 PMID: 33475717 https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2775159 - Colby K Unintended Consequences of Hand Sanitizer Use in the Coronavirus Disease 2019 Pandemic. JAMA Ophthalmol. 2021;139(3):352 PMID: 33475695 https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2775157
  8. Henderson J Benzene Found in Multiple Hand Sanitizer Brands. Known human carcinogen can be absorbed through the skin. MedPage Today March 25, 2021 https://www.medpagetoday.com/special-reports/exclusives/91806 - Valisure News. March 24, 2021 Valisure Detects Benzene in Hand Sanitizers. https://www.valisure.com/blog/valisure-news/valisure-detects-benzene-in-hand-sanitizers/