title: Prospective, randomized in vivo comparison of a dual-active waterless antiseptic versus two alcohol-only waterless antiseptics for surgical hand antisepsis.
abstract: BACKGROUND
  This study aimed to demonstrate the value of adding an active level of a persistent antimicrobial agent, such as chlorhexidine gluconate (CHG), to an alcohol-based surgical hand antiseptic.
  
  
  METHODS
  The persistence of 3 waterless, brushless alcohol-based surgical hand antiseptics, including one product containing CHG, was compared. The test products were applied a total of 12 times over 5 days. Samples of aerobic bacteria were collected on days 1 and 5, on both days immediately after drying and 6 hours later, using the glove juice technique. Relative suppression of regrowth was compared using t tests.
  
  
  RESULTS
  Using an equivalence margin of 20%, the alcohol plus CHG product showed noninferiority to the alcohol-only products at all sampling points and, based on significantly lower bacterial regrowth (P = .026), superior persistence to the alcohol-only products after 6 hours of glove wear.
  
  
  CONCLUSIONS
  Given the primary objective of surgical hand antisepsis of reducing resident skin flora for the duration of the surgical procedure, using an alcohol-based hand antiseptic containing CHG appears to be the most appropriate choice for maintaining microbial levels as low as possible for as long as possible.
authors.affiliation: 3M Infection Prevention Division, 3M Corporation, St Paul, MN, USA. lkolson2@mmm.com
authors.forename: Linda K M
authors.initials: LK
authors.lastname: Olson
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Morse
authors.forename: Collette
authors.initials: C
authors.lastname: Duley
authors.forename: Brenon K
authors.initials: BK
authors.lastname: Savell
mesh_terms: D000293:Adolescent; D000328:Adult; D000438:Alcohols / Q000494:pharmacology*; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D000985:Antisepsis / Q000379:methods*; D001420:Bacteria, Aerobic / Q000187:drug effects*; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000494:pharmacology; D015169:Colony Count, Microbial; D005260:Female; D005932:Gloves, Surgical / Q000382:microbiology*; D006225:Hand / Q000382:microbiology; D006235:Hand Disinfection / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012867:Skin / Q000382:microbiology
chemical_list: D000438:Alcohols; D000891:Anti-Infective Agents, Local; C010882:chlorhexidine gluconate; D002710:Chlorhexidine