Study Confirms No Link Between Real World Use of Antibacterial Soaps and Antibiotic Resistance

FOR IMMEDIATE RELEASE

Contact: Brian Sansoni (ACI), 202-662-2517 (office)/ 202-680-9327 (mobile) or via email at bsansoni@cleaninginstitute.org

Kathleen Dezio (Council), (202) 454-0302, deziok@personalcarecouncil.org

 

Study Confirms No Link Between Real World Use of Antibacterial Soaps and Antibiotic Resistance

  • Research in Peer-Reviewed Journal Reaffirms Safe Use of Triclosan, Triclocarban in Antibacterial Soaps and Washes
  • Study Discounts Claims That Antibacterial Products and Ingredients Contribute to Antibiotic Resistance

 

WASHINGTON, D.C., October 4, 2011– Newly published research reaffirms that the use of antibacterial wash products in the home environment does not contribute to antibiotic or antibacterial resistance, confirming previous research that showcased similar findings.

The study, published in the peer-reviewed International Journal of Microbiology Research, compared the use of over-the-counter antibacterial liquid hand and body cleansers and antibacterial bar soaps – containing the germ-killing ingredients triclosan and triclocarban – against the use of non-antibacterial cleansers.

Lead author Dr. Eugene Cole, who has spent more than 35 years in the field of environmental health research, says the study discounts claims that the use of antibacterial wash products have contributed to the selection and spread of drug-resistant bacteria on human skin.

Research Protocol

From a pool of more than 450 individuals, 210 study participants were randomly selected, 70 for each of three groups: 1) those that frequently used liquid bath or shower products containing triclosan; 2) those that frequently used bar soaps containing triclocarban; and 3) those that did not use any antibacterial wash products and thus served as the control group.

A standard method for swabbing both forearms of all participants was used to collect samples of Staphylococcus bacteria, which were then tested against several different types of antibiotics that are commonly used to treat Staph infections.

The experimental results showed that there was no increase in the antibiotic resistance of theStaph strains isolated from either group that had been using antibacterial wash products, when compared to those isolates obtained from the control group.  And those bacteria also showed no increased resistance to triclosan or triclocarban.

“There was no statistically significant difference in antibiotic resistance of Staphylococcus isolates obtained from the skin of regular antibacterial wash product users in comparison with non-antibacterial product users,” said Dr. Cole, Professor of Environmental Health Sciences of Brigham Young University’s Department of Health Science.  “There was also a definitive lack of antibiotic and antibacterial cross resistance among those bacteria.”

The research was supported by the American Cleaning Institute (ACI) and the Personal Care Products Council.

“Hygiene product manufacturers and ingredient suppliers continuously review and analyze research and fund new studies to ensure product and ingredient efficacy and safety.  This is part of our industry’s long-standing commitment to product stewardship,” said Dr. Francis Kruszewski, ACI Director of Human Health and Safety. “After decades of use, antibacterial wash products continue to play a beneficial role in everyday hygiene routines for millions of people around the world.”

Investigation of Antibiotic and Antibacterial Susceptibility and Resistance in Staphylococcus from the Skin of Users and Non-Users of Antibacterial Wash Products in Home Environments was authored by Dr. Eugene Cole, along with R.M. Addison, Duke University Medical Center, Clinical Microbiology/Infectious Diseases; P.D. Dulaney, Applied Environmental, Inc.;  K.E. Leese, Applied Environmental, Inc.; H.M. Madanat, San Diego State University, Graduate School of Public Health; and A.M. Guffey, Applied Environmental, Inc.

Links to this and other studies demonstrating the safety and effectiveness of antibacterial soaps are available online at www.FightGermsNow.com.

###

The American Cleaning Institute® (ACI – formerly The Soap and Detergent Association) is the Home of the U.S. Cleaning Products Industry® and represents the $30 billion U.S. cleaning products market.  ACI  members include the formulators of soaps, detergents, and general cleaning products used in household, commercial, industrial and institutional settings; companies that supply ingredients and finished packaging for these products; and oleochemical producers.  ACI (www.cleaninginstitute.org) and its members are dedicated to improving health and the quality of life through sustainable cleaning products and practices.

Based in Washington, D.C., the Personal Care Products Council is the leading national trade association representing the global cosmetic and personal care products industry. Founded in 1894, the Council’s more than 600 member companies manufacture, distribute, and supply the vast majority of finished personal care products marketed in the U.S. As the makers of a diverse range of products millions of consumers rely on every day, from sunscreens, toothpaste and shampoo to moisturizer, lipstick and fragrance, personal care products companies are global leaders committed to product safety, quality and innovation. For more information on cosmetic and personal care products, visit www.CosmeticsInfo.org.

  • Perry Romanowski

    Interesting study.  Two things occur to me.

    1.  This study does not look at what happens to the triclosan that goes down the drain and ends up in the sewer system.  It looks at bacteria left on people’s hands.  I think the primary complaints are about triclosan in the environment.

    2.  Where is the study showing the value of incorporating anti-bacterial ingredients into soaps?  There are lots of places that say it is not.

    • http://greenskincareblog.com/ Kristin Fraser Cotte

      Great points Perry. I was thinking the same thing along #1- from my understanding the danger lies in the water it runs off in.

      • Anonymous

        I wonder if the water/sewer treatment plants test for triclosan in drinking water before it’s allowed out into the pipes? Shoot, I’m not even sure triclosan can be removed. But asking the question of “what exactly am I drinking in my tap water?” could provide answers we don’t reeeaaallly want to know :)

        • Dene62

          The oral and dermal toxicity of triclosan is extremely low, so you don’t need to worry about drinking it – especially at “environmental” levels. The main issue is its toxicity towards aquatic species and its environmental persistance. I am not dismissing the importance of the environment; just saying YOU needn’t worry about drinking water!

          • Anonymous

            Colin and Dene, thank you. I had forgotten about the effects of triclosan on the viruses and bacteria already in the water before it’s treated. Although, wouldn’t that be easy or easier sampling?! There was an article out recently discussing the strange viruses and bacteria in water.

            Back to the article and study: Perry said it was regular people who had to report. What about the tobacco study? Using that as a template? Real world folks used to more meticulous reporting?

        • http://colinsbeautypages.co.uk Colin

          As Dene says, there isn’t any need to worry about triclosan in your drinking water.  There won’t be any there, and it wouldn’t do you any harm if it were.

          But there is a potential problem with drinking water in that water is treated by spraying it onto beds that use live micro-organisms that get rid of most of the contaminants.  Triclosan has been found to interfere with this process. It doesn’t seem to be a problem yet but triclosan use is increasing as the population increases.  Potentially any chemically stable fat soluble preservative might do the same.  (Dene knows which family I am thinking about).  It would be feasible to treat all water chemically but it would be a lot more expensive.  And we’d all end up paying more for our water.  This is annoying in a rich country, but could be a killer in a poor one.

          This isn’t as frightening as some of the stories you hear about triclosan, but it is a good example of how everything is interlinked and how things have surprising and unpredictable effects.

          • Dene62

            I think this article should address your concerns, Colin – http://personalcaretruth.com/2010/11/parabens-in-perspective-part-iii/ - and, at sublethal concentrations, parabens are metabolised by aerobic AND anaerobic bacteria so any environmental concerns are unfounded, but I would rather not turn this into a parabens discussion – so stop taunting me!!!!! :-)

    • Dene62

      I agree, Perry, but the study was not designed to address either of those points. It seems to have been specifically designed to address the question of antibiotic resistance so, on that particular point, I would say it was a success! There are many other studies that do address your two points, but I would suggest that this was never the intention of the study highlighted in this article.

      • Perry Romanowski

        Dene – I would contend that the title of this press release is the misleading part.

        “Study confirms no link between real world use of antibacterial soaps and antibiotic resistance”

        The implied message of this headline is that “Triclosan will not create antibiotic resistant bacteria.” 

        The study does not prove that despite what the headline writer wants you to think.  The title of this press release should be…

        “Study supports the theory that using antibacterial soaps won’t create antibiotic resistant  Staphylococcus bacteria on your hands”

        And if you look deeper into the study, there are two glaring problems.

        1.  They tested for one strain of bacteria?  This 2006 review of Triclosan and anti-bacterial resistance (http://www.liebertonline.com/doi/abs/10.1089/mdr.2006.12.83) suggests that antibiotic resistance is a concern among E. Coli and Samonella.  “recent laboratory studies have confirmed the potential for such a link in Escherichia coli and Salmonella enterica. ”  Where was the part of the study where they looked at other bacteria? 

        2.  210 individuals in the test?  The development of resistant bacteria will be a rare event indeed and could take multiple generations to show up.  And there are no controls on how often people washed their hands or what they used (seems self reported).  Weak, weak, weak.

        To say that this study CONFRIMS NO LINK is just non-scientific exaggeration.  To maintain their credibility the PCPC and the ACI should stop playing so fast and loose with the science.

        • Dene62

          Perry – I totally agree that the claims in the title of the press release are grossly over-inflated, although I can understand why only S. aureus was used, as this is the most notorious organism for developing antibiotic resistance. However, the study WOULD have had more value had they looked at other species over a longer period of time. I will admit that I was deliberately trying to be controversial, mostly because of the earlier “Vested Interest” accusation, but also because it has been far too quiet on here of late! :-)

          • Anonymous

            It sounds like we are dealing (again) with a journalist’s lack of understanding with science. Solid claims like the title are made far too frequently, IMO, so note that I am not singling this journalist out.

          • Perry Romanowski

            If only we could blame the skewed presentation of information on the “media”.  This post was a press release written by the ACI.  They seem to be using the same tactics as the EWG to manipulate research to fit a particular point of view. 

          • Anonymous

            (I tried) Not to be redundant but..this doesn’t help.

          • Anonymous

            Sorry for the apologist tone here.

  • http://www.awildsoapbar.com soapbartender

    My thoughts exactly.  There’s no need for antibacterial soaps in the first place and this study completely ignores triclosan in the environment. There’s nothing “real world” about it. And exactly who funded this study anyway?  I can’t tell for sure from the wording in the article, but if it was the American Cleaning Institute and the
    Personal Care Products Council as it suggests, it has profit driven motives written all over it.

    • Dene62

      Whilst I agree fully with your assessment of the need (or lack of) for antibacterial hand soaps, but I have to take issue with the use of a logical fallacy to try to undermine the results of the study. The source of the funding for this work cannot be used as a reason to dismiss the findings. You need to identify a flaw in either the methodology, or the interpretation of the results. From the information provided, it looks fairly robust to me.

      Why should the study have looked at the environmental impact? Should ALL studies on triclosan consider environmental impact? What would the purpose be? Why can’t a study (such as this specific one) have a different purpose – the absence of any environmental aspects doesn’t mean it is not valid? The study answers the question it was designed to answer. There are many environmental studies on triclosan that haven’t answered the resistance question, which is precisely why this one was undertaken.

      Sorry if I sound a little tetchy, but this “vested interest” argument is one of my pet hates; having personally been the victim of the same illogical accusation many times!

    • Anonymous

      This does sound more “real world’ than in a petri dish in a lab setting. The study itself needs to be looked at outside of the funding. Peer-reviewed, published, reproducible.
      By using the logic you suggest, I can easily dismiss any information provided by the American Wind Energy Association because they speak for wind energy. Or the EPA’s studies showing that we need more regulations on ozone because the EPA funded the studies.
      You have every reason to be skeptical but the study must be looked at independantly.

    • Perry Romanowski

      I agree with Dene here, just because the research is sponsored by the American Cleaning Institute and the PCPC doesn’t mean that the research is bad.  Scientists don’t just make data up because it supports what the research sponsors want to believe.

      If you have criticisms of the study, those should be pointed out.  But you can’t just dismiss peer-reviewed published research because of the people who funded it.

  • Anonymous

    This is good news. Does this study now need to be repeated?

  • http://colinsbeautypages.co.uk Colin

    It isn’t particularly surprising that treating skin with TCC or triclosan doesn’t increase resistance to antibiotics.  There has never been the slightest reason to believe that they would.  The observation that there was no increased resistance to the actives actually being used in the study is much more interesting.

    I have just had a look at the original paper and as the summary says, they didn’t detect any increase in resistance.  But the data is pretty variable, so I think it leaves open the possibility that resistance might have increased but the test wasn’t sensitive enough to pick it up.

    I know from my own work on triclosan that resistance is pretty easy to induce, which is what I suspect was probably going on in the one study that gets quoted over and over again that is supposed to prove that antibacterial soaps don’t work. At the very least, this study does show antibacterials actually killing bacteria on the skin.  Perry’s point about whether or not this has any benefit or not is a good one though.  Is reducing the skin’s bacterial count something that is worth bothering to do outside of a clinical setting?

    • Anonymous

      Isn’t triclosan an anti-inflammatory also? I seem to remember it being used in some toothpastes.

      I believe in the we-are-too-clean hypothesis. Don’t we humans need some of the bacteria, at least in the mouth? Soap removes dirt and some bacteria, baking soda can clean teeth. I guess, again, as you suggested is there any real benefit from having triclosan added to every day products? What is the goal that they’re trying to accomplish?

      • http://colinsbeautypages.co.uk Colin

        Triclosan is a very good anti-inflammatory, but it is a good question whether it is because it directly suppresses inflammation or because it removes the bacteria that are provoking it. It does work very well against impitigo where you have a real problem caused by a lot of staph aureus.  

        My personal feeling is that if the bacteria are present at such a low level that your skin can’t be asked to react to them, they are probably doing you no harm and killing them off with triclosan isn’t going to do anything much.  However if you are about to carry out invasive surgery or prepare food that isn’t going to be eaten straight away, other people might benefit from your use of an antibacterial.  Both these suggestions can be tested.

        The we are too clean hypothesis seems quite believable to me, but it needs a bit more work on it.  The benefits of hygiene are very well established.  It might well be that our obsession with hygiene is leading to unnecessary allergies. But we used to suffer from cholera epidemics.

  • Anonymous

    New Huffpo article and additional reading:

    http://www.huffingtonpost.com/sloan-barnett/germs-hand-sanitizer-_b_999230.html?ir=Green

    http://cid.oxfordjournals.org/content/45/Supplement_2/S137.full

    The second link states that triclosan has been used in products since the 1960’s. If that’s true, cool. But isn’t the antibiotic resistance and “superbacteria” a new thing?