Study of Alcohol-Based Handrubs is Questioned

In a letter to the editor of the journal Antimicrobial Resistance and Infection Control, Berthelot and Exner (2014) address the paper by Kampf, et al. (Kampf G, Ostermeyer C, Werner HP, Suchomel M: Efficacy of hand rubs with a low alcohol concentration listed as effective by a national hospital hygiene society in Europe. Antimicrob Resist Infect Control 2013, 2(1):19) comparing the efficacy of three alcohol-based handrubs (ABHR) according to EN 1500 and EN 14476. This study highlighted the possible variability of the results in different laboratories suggesting that the norm methods must be improved for a better standardization (EN 1500 and PrEN 1500). As Berthelot and Exner (2014) write, "Although the methodology of the experiments seems robust, we do not understand why only three products used in French hospitals were tested and why the positive list of the French Society for Hospital Hygiene (SFHH) was targeted by Kampf, et al. in the tittle and in the discussion section of the paper. As two of the authors are employed by Bode Chemie GmbH, a competing company of the French companies that manufactured the ABHR tested, there are real competing interests as mentioned at the end of the paper. We want to underscore also that this kind of paper is able to discredit some widely used products, represents a threat to hand hygiene promotion and the confidence in disinfectants if it is misunderstood and misused."

They add, "This study suggests that the norm methods to test ABHR efficacy must be improved for better standardization, but we don’t agree with all priorities proposed by Kampf, et al. to improve the validity of products and efficacy claims. We agree with the fulfilling of European pertinent norms and with the necessity to revise regularly the European norms to take into account the observed bias as for example the type of columns in the virucidal test. A better public control of norms and biocide authorizations is needed notably because of the increasing number of new ABHR products."