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Scientists should investigate whether saturating the skin with “good” bacteria would offer better protection against deadly germs, says the paper. Mark Spigelman, of the UCL Centre for Infectious Diseases and International Health, is calling for a study to be set up in hospital units in which antibiotics would be banned, to explore alternative health protection measures against MRSA.

In the paper, published in the November issue of Annals of the Royal College of Surgeons, Professor Spigelman says the time has come to re-evaluate the concept of using antibiotics and scrubbing hands and wounds with antiseptic soaps. His paper outlines a six-point proposal to set up surgical hospitals which would be antibiotic-free and would instead comply with the novel standard practices being investigated.

Professor Mark Spigelman says: “Inappropriate use of antibiotics remains a major problem, despite our ever-growing understanding of how bacteria behave. For example, any student who has grown bacteria in a lab will know that they generally do not grow on top of one another. So when we wash our hands, we could actually be killing off harmless commensals to the extent that we leave space for other bacteria, such as MRSA strains, to settle.

“Perhaps we should be thinking about using probiotics and even dipping our hands after thorough washing into a solution which contains harmless bacteria, which could then colonise our skin and prevent pathogenic bacteria from settling on it.

“It must be remembered that after almost 40 years, MRSA has not become widespread except in hospitals where we use the most advanced antibiotics and most rigorous antiseptic measures. Why is this? More of the same does not seem to be working – new antibiotics and antibacterial soaps have not stopped MRSA.

“The idea may sound absurd, but I believe that a probiotic cleaning procedure is an avenue worth exploring. To overcome the current epidemic of MRSA and other bacteria, we should aim to set up a handful of hospitals where the use of antibiotics would be banned, and any patients who needed them would be transferred to an antibiotic-using hospital. Doctors from these hospitals would not be allowed to enter hospitals which use antibiotics.

“At the same time we could trial the benefits of using ‘good’ bacteria to saturate the skin on doctors’ hands and even patients’ wounds prior to surgery, to see if this would prevent the settling of pathogenic, antibiotic-resistant bacteria. For instance, a surgeon who has spent the morning repeatedly scrubbing his or her hands in an operating theatre may well have got rid of many harmless skin commensals. When the surgeon then goes to the wards, the more virulent bacteria may settle into the areas left vacant. As a first step, the surgeon could use probiotics to try and prevent this sequence of events, for example by dipping their hands into a probiotic substance such as yoghurt.”

SOURCE: UCL Press Release

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2 Responses to Doctors to Wash their Hands of Antiseptic Soap

Aegis516

November 1st, 2005 at 10:55 am

The bad-colony preventing effects of saturating your skin with good colonies of bacteria is certainly plausible, but his call for a cessation to the use of antibiotics is ridiculous. If you don’t use antibiotics on your hands before this “good bacteria” dip then the same works in reverse. There are also virulent bacteria that are strong enough to displace or replace harmless strains. Viruses that one person has can also be spread via the hands and, unless the good bacteria also have a cleansing effect, would not be washed off by a simple probiotic dip. There are some holes in his argument and he would probably be better off to propose second study in which antibiotics and probiotics are used in concert. Though, that too could have a downside in that good bacteria that become antibiotic resistant (from repeated exposure through washing) would be able to share their resistance with harmful bacteria- and in the case of surgeons that could happen inside the patients body. Perhaps a study in a more controlled environment should be carried out before the reformation of any hospital anywhere.

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November 1st, 2005 at 11:05 am

I suspect that almost all hospital managers would be reluctant to even consider going antibiotic free, unless rigorous trials had taken place of the yoghurt solution. Moreover, this notion of banning doctors from antibiotic free hospitals…would that have to be extended to para-medical staff and others too. We could end up with a divided culture (pardon the pun) in which society became split down the middle with the pro- on one side and the anti-biotic on the other.

His ideas sound plausible, but like you say, a lot more work needs to be done, before such measures could ever be implemented without running the risk of virulent pathogens running even more rampantly around our medical centres than they already do.

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