Efficacy of Triclosan as an Antimicrobial Hand Soap and Its Potential Impact on Antimicrobial Resistance: A Focused Review

Abstract

Triclosan is a synthetic biocide found in many household products, including antimicrobial hand soap. Levels of triclosan have been found throughout the environment and in human urine, blood, and even breast milk. Increasing levels of exposure to triclosan have led to concerns over the development of resistance to triclosan and cross-resistance to other antimicrobials. We performed a literature search to assess whether the widespread use of triclosan displays a favorable benefit: risk ratio, defined by evaluation of triclosan's efficacy as an antimicrobial hand soap and its potential effect on the development of antimicrobial resistance. Data from laboratory-based studies regarding the efficacy of triclosan are conflicting, although well-designed studies suggest no significant difference in efficacy over nonantimicrobial soap. In addition, when triclosan was introduced in a community setting, no beneficial effects were observed on the reduction of infections over nonantimicrobial soap. Resistance to triclosan and cross-resistance to antimicrobials have been consistently demonstrated in laboratory settings, although overall resistance rates and cross-resistance rates in the community setting are low. Based on the available evidence, the risk of potential antimicrobial resistance outweighs the benefit of widespread triclosan use in antimicrobial soaps.

Decolonization in Prevention of Health Care-Associated Infections

“…They concluded that there was no beneficial effect of triclosan over nonantimicrobial soap, and triclosan resistance has been demonstrated. They concluded that the risks outweighs the benefits of triclosan use (124).…”

A One Health approach to antimicrobial resistance surveillance: is there a business case for it?

“…The combined surveillance would also facilitate monitoring of the impact of interventions aimed to improve antibiotic stewardship and reduce consumption [9]. The widespread use of biocidal soaps and gels versus simple soap hand washing and the benefits of potentially reducing the spread institutional infections versus contributing to AMR is another area for consideration [25]. Rushton (2015) [14] stated that antimicrobials should be seen as a common good.…”

The Threat and Response to Infectious Diseases (Revised)

“…For instance, it has been regularly demonstrated in the laboratory that resistance to triclosan, an antimicrobial agent used in many household products including hand sanitizer, and crossresistance to antimicrobials increases with use of triclosan containing products; however these results have not yet been observed in the community. Based on the available evidence, the risk of potential antimicrobial resistance outweighs the benefit of widespread triclosan use in antimicrobial soaps [57].…”