CDC's advice to doctors: Clean your hands

New guidelines emphasize the role of hand hygiene in reducing the spread of infection.

Editorial. Nov. 25, 2002.

Each year, about 2 million American patients develop infections while hospitalized. An estimated 90,000 of them die as a result. Additionally, infections are a complication of care in numerous other settings, including long-term-care facilities and clinics.

The problem revealed by these statistics is not new. But reducing its cost, in terms of human suffering as well as actual health care dollars, is literally within reach. Physicians and other health care professionals could make significant inroads by increasing their vigilance in a key area: hand hygiene. And that's why the Centers for Disease Control and Prevention last month issued new guidelines on this very topic.

The agency's directive, which is in sync with current American Medical Association policy, is very clear: Clean 'em up.

"Clean hands are the single most important factor in preventing the spread of dangerous germs and antibiotic resistance in health care settings," said CDC director Julie Gerberding, MD, MPH.

The American Medical Association has long advanced the importance of hand hygiene in minimizing the spread of infection, both within the practice of medicine and among members of the general population.

Now, the CDC guidelines move into new territory by advising the use of alcohol-based hand rubs by health care professionals in addition to traditional hand washing with soap and water.

First off, recent studies indicate that these hand rubs reduce the number of bacteria on hands more effectively than does soap and water. These products should not be confused with anti-microbial soaps, gels and lotions that have proliferated the consumer market. While the AMA has raised red flags about these anti-microbials and their possible role in antibiotic resistance, alcohol rubs do not pose the same risk. [...]