Antibacterial Soaps

[Charlie B53]

Another thread broached the subject of using antibacterial soaps.  I told how my Neph and Nurse at our last Clinic talked about regularly switching the antibacterial oinment we used on our PD site to prevent infections.  Many of us use antibacterial soaps for the same reason.  I do.

I had the thought that perhaps we also should be changing soaps regularly to prevent bacteria from immunizing to any one particular antibacterial soap.  and I suggested this be looked into.

I Googled 'antibacterial soaps'  https://www.google.com/search?q=Antibacterial+soaps&ie=utf-8&oe=utf-8

And started reading the listings provided.

I was shocked at what I found.   We see and hear all this advertising spiel.  And come to find out that is pretty much that is all it is.  Spiel.  So I copied and pasted quotes from a couple of these to perhaps save you a little time from reading them all.   Most are basically parroting what I have below.

Take Care,

Charlie B53


Quotes taken from   http://articles.mercola.com/sites/articles/archive/2015/09/29/antibacterial-soap.aspx

A survey by the American Cleaning Institute and the industry-run Personal Care Products Council revealed that 74 percent of Americans use antibacterial soap.
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Such soaps may have their place, such as in an operating room prior to surgery, but they’re being vastly overused in homes, schools, restaurants, and other settings with potentially devastating consequences.
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The actual health and environmental risks of antibacterial soap have only relatively recently been uncovered, and they’re still not widely known, at least among consumers. Hopefully, the tide is beginning to turn, however, as yet another study has shown no significant benefit to using antibacterial soap.
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In December 2013, the US Food and Drug Administration (FDA) proposed a rule stating that manufacturers must provide data to demonstrate that antibacterial soap is more effective than plain soap and water.

The current study examined this question by exposing 20 FDA-proposed bacterial strains to plain or antibacterial soaps.2

The bacterial strains included Escherichia coli, Listeria monocytogenes, and Salmonella enteritidis, among others, and the antibacterial soap used the same formulation as plain soap, but containing 0.3 percent triclosan (the most widely used antiseptic agent in soap, as the maximum concentration allowed by law).

The bacteria were exposed to the soaps in petri dishes for 20 seconds at 22°C (room temperature) and 40°C (warm temperature) in order to simulate hand-washing conditions typically used by adults.

The bacteria were also spread onto the hands of study volunteers, who then washed their hands for 30 seconds using either type of soap and warm temperature water. The researchers found:

    “Antibacterial soap containing triclosan (0.3 percent) was no more effective than plain soap at reducing bacterial contamination when used under 'real-life' conditions.”

It was only after the bacteria were soaked in antibacterial soap for nine hours that the triclosan-containing soap killed more bacteria than the plain soap – a clearly useless “benefit” for the average consumer.

The study’s lead researcher noted that exaggerating the effectiveness of antibacterial products should be banned, as it can confuse consumers.
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My notes;  The above article is much longer and includes information in other areas, such as;
You’re Just as Likely to Get a Cough, Cold, Stomach ‘Flu,’ and Other Symptoms
Triclosan Is Harmful to Human Health
Antibiotic Resistance and Environmental Threats
Kids Getting Poisoned by Hand Sanitizer
Tips for Effective Hand Washing



Quotes taken from Wiki;  https://en.wikipedia.org/wiki/Antibacterial_soap

Antibacterial soap is any cleaning product to which active antimicrobial ingredients have been added.[citation needed] These chemicals kill bacteria and microbes[which?], but are no more effective at deactivating viruses than any other kind of soap or detergent, and they also kill nonpathogenic bacteria.[1][better source needed] According to the FDA, there is no evidence that antibacterial products are more effective than soap and water, and products which contain triclosan do not show that they reduce the transmission of respiratory or gastrointestinal infections
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Most liquid hand and body soaps contain antibacterial chemicals.[citation needed] These are only contained at preservative levels unless the product is marked antibacterial, antiseptic, or germicidal.[citation needed] Triclosan, triclocarban, and chloroxylenol are commonly used for antibacterial and deodorant effect in consumer products.[citation needed] Some soaps contain tetrasodium EDTA which is a chelating agent that sequesters metals that the bacteria require in order to grow.[citation needed] Other microbes also require metals and so it is actually an anti-microbial agent that is widely used even as a preservative
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Recent research from the Mo Bio Laboratories in California suggests that antibacterial hand soaps have no effect on deactivating viruses.[relevant? – discuss] The study states "water alone was very effective so perhaps the water following soap helped to solubilize more virus. However, water alone with rubbing has the best reduction in virus and the rubbing with soap followed by water does not have an additive effect." Furthermore, ethanol-based solutions such as general hand sanitizers have no effect on viruses.

Studies have examined the purported benefits of antibacterial soap without clear consensus about the results. Some studies have concluded that simply washing thoroughly with plain soap is sufficient to reduce bacteria and, further, is effective against viruses. Other studies have found that soaps containing antimicrobial active ingredients remove more bacteria than simply washing with plain soap and water.[3][4] The U.S. Food and Drug Administration published reports that question the use of antibacterial soap and hand sanitizers saying that it found no medical studies that showed a link between a specific consumer antibacterial product and a decline in infection rates.[5]

At one conference, Stuart Levy, a microbiologist at Tufts University, cites these studies to compare antibacterial action with antibiotic resistance: "Dousing everything we touch with antibacterial soaps and taking antibiotic medications at the first sign of a cold can upset the natural balance of microorganisms in and around us, leaving behind only the 'superbugs'."1 See Triclosan#Resistance concerns

It has since been shown that the laboratory method used by Levy was not effective in predicting bacterial resistance for biocides like triclosan.[6] At least seven peer-reviewed and published studies have been conducted demonstrating that triclosan is not significantly associated with bacterial resistance over the short term, including one study coauthored by Levy.
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Quoted taken from a lightly written slightly humorous article in Scientific American;
http://blogs.scientificamerican.com/guest-blog/scientists-discover-that-antimicrobial-wipes-and-soaps-may-be-making-you-and-society-sick/
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For example, in a study Aiello reviewed that was conducted in Pakistan, gastrointestinal illnesses were reduced by half when people washed their hands with soap and by a little less than half when they washed their hands with antibiotic soap [3]. What is worse, perhaps the most comprehensive study of the effectiveness of antibiotic and non-antibiotic soaps in the U.S., led by Elaine Larson at Columbia University (with Aiello as a coauthor), found that while for healthy hand washers there was no difference between the effects of the two, for chronically sick patients (those with asthma and diabetes, for example) antibiotic soaps were actually associated with increases in the frequencies of fevers, runny noses and coughs [4]. In other words, antibiotic soaps appeared to have made those patients sicker. Let me say that again: Most people who use antibiotic soap are no healthier than those who use normal soap. AND those individuals who are chronically sick and use antibiotic soap appear to get SICKER.
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[kickingandscreaming]

From everything I've read, Triclosan is a a bad news ingredient and promotes resistance.  I read the labels of the antibacterial products that i am given to use by  my PD center.  None of them contain this ingredient.  I use Dial soap, Alcavis50 and ExSept and none of them has this.  Viruses are not the main issue in antibacterial soaps as they are not bacteria.  Pretty much nothing (topical) kills viruses so that isn't a good metric to use to decide if a product is good or not.  In PD, most of the culprits are bacterial--primarily Staph aureus and Pseudomonas.

I don't know about the switching of bacterial ointments for the exit site.  Not sure if switching prevent resistance. I'd be interested to know more about this.  I was using only Medihoney for a while on my exit site.  But then I mentioned that to my Nephro last week and she went through the ceiling--adamantly saying that this clinic's protocol is gentimicin and only gentimicin and that it has been used for 5 years without any issues.  In deference to her adamancy, I am now using both.  I put the genimicin directly on the exit site and put the Medihoney on my dressing.  Medihoney has been shown to NOT cause antibiotic resistance so I am backing up my gentimicin with an extra insurance policy.  I have read that Medihoney has a synergistic effect with Mupirocin, but not with Gentimicin.  But that doesn't mean that it isn't killing off bad guys that escape the Gentimicin.  Because that's how antibiotic resistance happens: the medicine isn't 100% bacteriocidal.  Some of the bad guys survive as they have resistance and they reproduce and continue a line of similarly resistant bad guy babies. Medihoney, from what I've read, disable the bacteria and make them unable to reproduce.

http://news.nationalgeographic.com/news/2009/09/090908-mrsa-staph-manuka-honey.html
MRSA bacteria treated with manuka honey more often lacked a particular protein necessary for synthesizing fatty acids, which are required for building cell walls and internal structures.The crippled bacteria "don't have the necessary proteins to complete their life cycles," Jenkins said, so they are unable to reproduce and eventually die.

[Charlie B53]

Three years ago when I had my cath placed, I was one of the participants in a medhoney study.  from day one Medhoney was placed directly on mmy site at EVERY dressing change.  I still have part of a tube.  My Clinic was also involved in the study, one of the research documentors would see me at every visit  I had at Clinic, check the progress of my healing from the surgery, and take pictures .  This went on for months, it maay have only been 90 days as that was three years ago, my memory isn't what it once was.

I had long talks with this guy, he taught me a LOT about  PD as he was involved from the beginning, doing the documentation for two of the main Dr's (Professors) that designed and developed PD as we know it now.   This all occurred at the University of Missouri Hospital in Columbia, Missouri around the early 1970's in response to a plea from another Dr (a former classmate of one of the Professors) in Texas that had a patient driving many miles to come into that Hospital for PD in the Emergency room.  I don't' remember the frequency of his treatments, only that prior to the development of PD it was done in the ER.  Without an implanted cath.

I was very impressed with this Guy, that he had a history being involved with the development of out treatment.  And that he seemed so willing to spend the time to tell me about it.  That I was involved in one of the studies he was doing was an added bonus.


At the end of the Medhoney study my Clinic started me on Mupircin (Spelling?).  At this months Clinic we discussed switching to the gentimicin, for a period.  Someday switching again.  I don't recall what the period for each ointment will be or if there are others approved for our use.

[pinkyD]

My education has taught me to be wary of overuse of antibiotics. I personally don't use antibacterial anything, except for alcohol based hand sanitizer. I had been instructed to use antibac hand soap and body wash, but use regular. I just take very good care of my exit site, wash hands for 1 min., always mask-up, and keep everything clean. No peritonitis yet! Knock on wood.

[Charlie B53]

PinkyD, how long have you been doing PD now?

I started just three years ago.  No Peritonitis.  But I have had a few hospitalizations from unrelated infections, leg, abscess on my butt, right ear inner infection.

Dr's tried to convince me this lst time that I did have peritonitis, but I had NO symptoms and my drain samples were perfectly clear.  I insisted they retest, there was no problem, lab came back fine.  Did scare me a bit,  I've been wrong before.   Just not this time.

[Simon Dog]

I've been wrong before.   Just not this time.

I thought I was wrong once, but I turned out to be mistaken about that.

[stayingalive]

I was told not to use hand soap for showering or before hooking up for pd.  For that I use anti-bacterial soap.  Two reasons they said...1) a small piece of soap could flake off and get by the entry site that I can't see that may lead to infection.  2)  no washcloth because no chance taken of being in a hurry getting to close to entry site and possible irritating or causing a possible opening around entry site...again could be opening for infection.  Of course I also use the non-alchohol based hand sanitizer after washing hands when getting PD ready.  I think maybe some of the differences may be coming because our Nephs have certain ways that have worked for them.  Of course I am always telling mine I am different than most.....after talking with me for a bit he knew lol  Just keep trying what your Neph suggests and question it if you don't think its for you.  Continued GOOD LUCK to all and May God Bless!!!

[PrimeTimer]

You were right, Charlie B53. The FDA has now banned anti-bacterial soaps containing Triclosan. They have given companies 1 year to remove this ingredient from their products. Wonder what the clinics and hospitals are going to use now. Wonder what they are going to have those who do home dialysis use.

http://www.npr.org/sections/health-shots/2016/09/02/492394717/fda-bans-19-chemicals-used-in-antibacterial-soaps

[Charlie B53]

So the FDA is going to play the game of catch-up.  Soap makeers will simply change their formulation knowing they will have a free year before FDA demands proof of effectiveness of the new mix.  It will take at least another year before FDA bans the new chemicals then the soap makers simply change again.  And repeat the cycle over and over.

Much like the designer drug industry.  Modify the molecule slightly, still get high until the FDA identifys the new formula and passes a measure making it illegal.  Change it again, repeat again and agin.  It was years before the FDA passed a measure declaring ALL forms of the basic molecule illegal.. Game over.   I went straight.