Comprehensive evaluation of the most important agents for hand hygienea

Criterion for evaluationEffect for:
Plain soap (hand wash)Chlorhexidine (2-4%) (hand wash)Triclosan (1-2%) (hand wash)Ethanol (60-85%) (hand rub)Isopropanol (60-80%) (hand rub)n-Propanol (60-80%) (hand rub)
Spectrum of activity
    Bacterial spores
    Coated viruses++Unknown+++++++++
    Uncoated virusesb+Unknown+c(+)d(+)d
Effect on hand flora (mean log10 reduction)
    Transient bacteria (≤1 min)0.5-32.1-32.82.6-4.54.0-6.814.3-5.8
    Resident bacteria (≤3 min)≤0.40.35-1.750.29-
Potential for acquired bacterial resistanceModerateLowNoneNoneNone
Effect on skin
    Skin hydrationDecreaseDecreaseDecreaseNo changeNo changeNo change
    Skin barrierImpairedImpairedImpairedNo changeNo changeNo change
    Skin irritationLikelyLikelyPossibleVery uncommonVery uncommonVery uncommon
    AllergyUncommonPossibleUncommonExtremely uncommoneNoneNone
Effect on compliance with hand hygiene(↓)(↓)(↓)(↑)
  • a +++, effective within 30 s; ++, effective within 2 min; +, effective in >2 min; (+), partially effective; −, not effective.

  • b Poliovirus and adenovirus, test viruses of prEN 14476.

  • c Ethanol at 95% has virucidal activity within 2 min.

  • d Results largely dependent on the test virus.

  • e Individual cases, possibly due to impurities.