Table 2.

Hand hygiene: materials and efficacy

Agent	Plain soap	Antimicrobial soap with chlorhexidine	Alcohol based hand sanitizer
Mode of action	Detergent effect and mechanical friction	Cationic bisguanide, disrupts cell membranes	Disrupts membranes, denatures proteins, cell lysis
Reduction of bacterial load on hands	0.6 to 1.1 log10 CFU	2.1 to 3.0 log10 CFU; has persistent residual antiseptic activity on the skin which may last up to 30 min.	3.2 to 5.8 log10 CFU
Effective against	Dirt, organic material	Gram-positive cocci	Gram-positive cocci, gram-negative bacilli, mycobacterium tuberculosis, fungi, viruses
Less effective against		Gram-negative bacilli, fungi and viruses, mycobacteria, spore forming bacteria such as Clostridium difficile	Clostridium difficile, Hepatitis A, rotavirus, enteroviruses, adenovirus, spores
Comments	Trauma caused by frequent skin washing may lead to chapping of skin and shedding of resistant flora		Optimal antimicrobial activity at concentration of 60–90%

(from ref [21] and [28])