TABLE 9.

Comprehensive evaluation of the most important agents for hand hygiene^a

Criterion for evaluation	Effect for:
	Plain soap (hand wash)	Chlorhexidine (2-4%) (hand wash)	Triclosan (1-2%) (hand wash)	Ethanol (60-85%) (hand rub)	Isopropanol (60-80%) (hand rub)	n-Propanol (60-80%) (hand rub)
Spectrum of activity
Bacteria	−	++	++	+++	+++	+++
Mycobacteria	−	(+)	Unknown	+++	+++	+++
Bacterial spores	−	−	−	−	−	−
Yeasts	−	++	++	+++	+++	+++
Dermatophytes	−	−	+	++	Unknown	Unknown
Coated viruses	−	++	Unknown	+++	+++	+++
Uncoated virusesb	−	+	Unknown	+c	(+)d	(+)d
Effect on hand flora (mean log10 reduction)
Transient bacteria (≤1 min)	0.5-3	2.1-3	2.8	2.6-4.5	4.0-6.81	4.3-5.8
Resident bacteria (≤3 min)	≤0.4	0.35-1.75	0.29-0.8	2.4	1.5-2.4	2.0-2.9
Potential for acquired bacterial resistance	−	Moderate	Low	None	None	None
Effect on skin
Skin hydration	Decrease	Decrease	Decrease	No change	No change	No change
Skin barrier	Impaired	Impaired	Impaired	No change	No change	No change
Skin irritation	Likely	Likely	Possible	Very uncommon	Very uncommon	Very uncommon
Allergy	Uncommon	Possible	Uncommon	Extremely uncommone	None	None
Effect on compliance with hand hygiene	(↓)	(↓)	(↓)	(↑)	↑	↑

^a+++, effective within 30 s; ++, effective within 2 min; +, effective in >2 min; (+), partially effective; −, not effective.

^bPoliovirus and adenovirus, test viruses of prEN 14476.

^cEthanol at 95% has virucidal activity within 2 min.

^dResults largely dependent on the test virus.

^eIndividual cases, possibly due to impurities.