Antibiotics have been added to soaps, shampoos, laundry products, deodorants, and many other personal care products that manufacturers then label as “antibacterial” and increase the price. The most frequently used antibiotic is Triclosan. Although triclosan reduces germ counts in the laboratory more than simple soap, there are no studies demonstrating that triclosan-containing products actually reduce personal or household infections. The majority of household illnesses are due to viruses which are not affected by antibiotics. Indeed, a recent study of households randomly assigned to either antibacterial or non-antibacterial hand washing, cleaning, and laundry products showed no difference over a 1 year period in the occurrence of symptoms typically attributable to viral illnesses. But the absence of a benefit in reducing viral symptoms likely predicts that overall household health will not be greatly benefited by the use of antiseptic products, because viral illnesses are so much more common than those due to bacteria. Despite the fact that triclosan benefits in reducing actual infections are theoretical and based on laboratory germ counts, the antibiotic can now be found in as many as three-quarters of all liquid soaps marketed to households in the U.S.
Whenever widespread exposure to antibiotics is considered, so too must the development of antibiotic resistance be considered (see Chapter 5, Germ Proof Your Kids – The Complete Guide to Protecting (without Overprotecting) Your Family from Infections (ASM Press, Washington, D.C., 2008). Resistance results from the conditioning or acclimating of resident germs to their environments. When anti-microbial substances are part of that environment, germs that are naturally or mutationally resistant to those substances have a selective advantage and outgrow the sensitive bugs. Initial concerns regarding triclosan, in particular, have been largely resolved regarding resistance – it does not appear that the use of triclosan in the household, even continuously for a year, results in the emergence of resistant germs. However, recall, that it is also not proven that triclosan-containing products are in any way advantageous over non-antibiotic cleaning products in reducing personal or household infections.
The absence of evidence suggesting an advantage of antiseptic soaps, and the theoretical risks of increasing resistance (although also not actually observed to date), prompted an FDA Advisory Panel to recommend in October of 2005 against these products for home use, in favor of simple soap.
But now for the really silly part. Triclosan has now been incorporated into dozens (DOZENS!) of inanimate objects like floor tiling, countertops, toys, clothes, combs, brushes, and, of course toilet seats. On the school supply aisle, you can now find antibiotic impregnated scissosrs, rulers, protractors, and compasses! No one has yet explained to me (or anyone else) how the antibiotic on the protractor and the compass gets out to kill the geometry germs that land on it, or whether any reduction in germs occurs at all – and certainly no one has shown any decrease in infections from antibiotic-laced scissors. But…the plastic scissors without the antibiotic cost $0.99 while the antibiotic-impregnated plastic scissors are $2.49. And that, my friends, apparently is motive enough to put antibiotics into everything that we touch.
What’s the solution? Don’t put antibiotics into anything. Rather, effectively clean surfaces that tend to accumulate germs – that’s a proven technique for reducinig actual infections and keeping households healthier (see Dr. Rotbart’s GERMBlog entry of August 3, 2008 for Home Hot Zones and effective surface disinfecting; and see Chapter 9 of Germ Proof Your Kids – The Complete Guide to Protecting (without Overprotecting) Your Family from Infections).