title: Comparison of the immediate, residual, and cumulative antibacterial effects of Novaderm R,* Novascrub R,* Betadine Surgical Scrub, Hibiclens, and liquid soap.
abstract: BACKGROUND
  Triclosan (Irgasan), an antibacterial active against staphylococci and coliform bacteria, has been formulated for use as a handwash. There has been only one previous report of the use of the glove juice test to determine the immediate, residual, and cumulative effects of a 1% triclosan-based handwash product. There have been no previous studies on the use of 1% triclosan combined with povidone-iodine (PI) in a handwash product.
  
  
  METHODS
  The glove juice technique was used to document and compare the immediate, 3-hour residual, and 5-day cumulative effects on the mean log10 bacterial counts of 1% triclosan-based handwash product and 1% triclosan with 5% PI. A standardized surgical handwashing technique was used before sample collection. These results and the identity and type of the aerobic bacteria cultured from the samples were compared with the results of standardized washing and glove juice sampling with 4% weight/volume chlorhexidine gluconate (CHG), 7.5% PI, and a nonantimicrobial liquid soap.
  
  
  RESULTS
  All five tested products showed significant log10 reduction from baseline on day 1, hour 0 (p < 0.05). There was no significant difference between the mean log10 bacterial count when 7.5% PI, 4% CHG, and 1% triclosan with 5% PI were compared with each other immediately after washing (p > 0.05). There was a significant difference between 1% triclosan and the liquid soap when they were each compared with 4% CHG, 7.5% PI, and 1% triclosan with 5% PI. There was no statistically significant difference between the 1% triclosan product and the liquid soap (p > 0.20). All products were effective at reducing the immediate bacterial count from the baseline level. All formulations except the liquid soap showed significant cumulative effect (p < 0.05) after multiple washes, with no significant difference between the cumulative effects of the liquid soap and 1% triclosan (p > 0.05). Both products differed significantly (p < 0.05) from the CHG, PI, and triclosan with PI. CHG, PI, and triclosan with PI showed effects significantly different from each other (p < 0.05).
  
  
  CONCLUSIONS
  Triclosan combined with PI resulted in the prevention of bacterial regrowth at 3 hours such as occurred when PI alone was used. Triclosan-containing products have a small cumulative effect, although not as great as that produced by CHG. The triclosan-based products did not appear to select for gram-negative bacterial overgrowth, although the study period may have been too short to detect such an effect.
authors.affiliation: Department of Microbiology, Royal Brisbane Hospital, Herston, Queensland, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Faoagali
authors.forename: J
authors.initials: J
authors.lastname: Fong
authors.forename: N
authors.initials: N
authors.lastname: George
authors.forename: P
authors.initials: P
authors.lastname: Mahoney
authors.forename: V
authors.initials: V
authors.lastname: O'Rourke
mesh_terms: D000293:Adolescent; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D001420:Bacteria, Aerobic / Q000187:drug effects / Q000302:isolation & purification; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000494:pharmacology; D005260:Female; D006235:Hand Disinfection / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010564:Personnel, Hospital; D011206:Povidone-Iodine / Q000494:pharmacology*; D012915:Soaps / Q000494:pharmacology; D013048:Specimen Handling; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000302:isolation & purification; D013997:Time Factors; D014260:Triclosan / Q000494:pharmacology*
chemical_list: D000891:Anti-Infective Agents, Local; D012915:Soaps; D014260:Triclosan; D011206:Povidone-Iodine; C010882:chlorhexidine gluconate; D002710:Chlorhexidine