Friday, October 21, 2005, 14:33 EDT Leave a comment Go to comments

When my son was younger, his pediatrician—unlike many others—deliberately avoided prescribing antibiotics for infections that he was reasonably sure were bacterial. For Dr. “H”, reasonable certainty meant a positive strep culture, for example, or the recognizable telltale signs of bacterial infection. He explained that he was concerned about the overuse of antibiotics "just in case" or to appease parents who insisted on an antibiotic even for a viral illness, such overuse being possibly related to the development of drug-resistant bacterial strains.

When antibacterial soaps became popular for household use several years ago, I wondered if they might also do more harm than good in the long run. I was aware that there are some bacteria that serve

An advisory panel to the U.S. Food and Drug Administration apparently has the same concern, although they have no definitive clinical evidence it.

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.

[ . . . ]

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.

If the study does not substantiate fears of resistance, why worry about these products? Because we know that other bacteria have become resistant to drugs once thought to be sure things. In many cases, it takes decades for the resistance to develop. And household antibacterials have not been widely used for nearly that long.

It seems prudent to adopt a conservative approach—do the minimum you need to do to accomplish the desired result, and save the big guns for more desperate situations. If plain soap and water effectively remove bacteria from the skin—which is, after all, the goal of hand-washing—there is no need to kill the bacteria on their way down the drain just because we can. Especially if it merely creates more problems down the road.

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