Antibacterial soaps and washes aren't any better
than plain, old soap and water for fighting illness in
the household, says a panel of federal health advisers.
They warned manufacturers they will have to prove
their products' benefits or they may be restricted from
marketing them.
Dr. Alastair Wood, chairman of the panel which
met Thursday to advise the Food and Drug Administration,
said he saw no reason to purchase antibacterial products,
given they generally cost more than soap.
The advisers also worried the potential risks of
the products, particularly the common hand soaps and body
washes that use synthetic chemicals, create an environmental
hazard and could contribute to the growth of bacteria
that are resistant to antibiotics.
"I think we're seeing a lot of sentiment against
(antibacterials) being marketed to the consumer" unless
they can show some added benefit over regular soap and
water, said Dr. Mary E. Tinetti, a member of the panel.
Industry representatives contend their products
are safe and more effective than conventional soaps, because
they kill germs instead of just washing them off. They
said consumers should have a right to choose their products
in a free market.
Their products have grown significantly in popularity
in the last decade, as consumers decided killing germs
was better than simply washing them down the drain.
But the FDA said controlled studies found no significant
difference in infections in households using antibacterial
products and those with regular soap and water.
On Thursday, the agency's Nonprescription Drugs
Advisory Panel, composed of independent experts, recommended
no specific regulatory action against the manufacturers,
but called on FDA to study the products' risks versus
their benefits.
The agency has the authority to order warning labels
on the products or place restrictions on how they are
marketed to the public. Susan Johnson, associate director
of nonprescription products for the FDA, said the agency
would pay close attention to the panel's concerns.
FDA officials and panelists raised concerns about
whether the antibacterials contribute to the growth of
drug-resistant bacteria, and said the agency has not found
any medical studies that definitively linked specific
antibacterial products to reduced infection rates.
Dr. Stuart B. Levy, president of the Alliance for
Prudent Use of Antibiotics, said laboratory studies have
suggested the soaps sometimes leave behind bacteria that
have a better ability to flush threatening substances
_ from antibacterial soap chemicals to antibiotics _ from
their system.
"What we're seeing is evolution in action," he
said of the process.
He advocated restricting antibacterial products
from consumer use, leaving them solely for hospitals and
homes with very sick people.
"Bacteria are not going to be destroyed," he said.
"They've seen dinosaurs come and go. They will be happy
to see us come and go. Any attempt to sterilize our home
is fraught with failure."
Levy said overuse of antibiotics is the main cause
of bacteria developing resistance to them. He acknowledged
that a yearlong study showed that homes using antibacterial
soaps did not show an increase in resistant bacteria in
significant numbers, but he argued the soaps will still
contribute to resistance over a longer period.
Industry representatives said they would provide
more information to FDA about their products safety and
effectiveness.
"The importance of controlling bacteria in the
home is no different than the professional setting," said
Elizabeth Anderson, associate general counsel for the
Cosmetic, Toiletry and Fragrance Association. "We feel
strongly that consumers must continue to have the choice
to use these products."
Panelists also distinguished alcohol-based hand
cleansers from antibacterial soaps and washes. The cleansers
are particularly useful in situations in which soap and
water are not available.