WASHINGTON – Medical professionals warned the Food and Drug Administration on Thursday that antibacterial soaps and cleaning products offer no more disease protection than regular soap and could make bacteria resistant to antibiotics in the long run.
That might be startling to many Americans,whose attitudes toward bacteria – reflected by escalated sales of antibacterial products – seem to be increasingly seek-and-destroy. But doctors insist bacteria aren't going anywhere.
“They've seen dinosaurs come and go; they'd be happy to see us come and go,” said Dr. Stuart Levy,president of the Alliance for the Prudent Use of Antibiotics. “We should be cautious and we should be concerned.”
Other groups,including the Soap and Detergent Association,however,point to studies that show negligible increases in bacterial resistance. Such studies,however,are usually conducted over months or a year.
One such study,which examined household use of antibacterial products,was done by Levy and Dr. Allison Aiello of the University of Michigan and a committee member. They found that bacteria did not build significant drug resistance after one year. But they suggested that negative long-term effects are likely and that further surveillance is needed.
Some members of the Nonprescription Drugs Advisory Committee said the long term is often difficult or impossible to test,but that that shouldn't confound their hypothesis.
“Absence of evidence is not evidence of absence,” said John Powers of the FDA's antimicrobial drug development and resistance initiatives.
In any case,committee members said it's better to use regular soap,because there's no point in tempting fate by using products proved no better by several studies.
One committee member,Dr. Rolf Halden of Johns Hopkins University,said that if these products' chemicals,namely triclosan and triclocarbon,do indeed lead to resistance,worrying is the next step,because the chemicals are pervasive.
The chemicals are treated incompletely in sewage plants and pumped back into the soil,where they can be ingested by animals and absorbed by plants,Halden said.
“Produced faster than they degrade,” he said,at least 150,000 pounds of both triclosan and triclocarbon are applied to agricultural land yearly. To him,that explains why drinking water,fish,fruit juice,blood and urine often contain them.
“There's so much going around,it's actually excreted again,” he said.
Committee members acknowledged that not enough data support their predictions. For example,it's difficult to gather triclocarbon data,because those who collect them are industry members,who tend to safeguard their findings. Still,Halden said,there are “known risks we need to consider.”
The FDA has the power to put warning labels on or restrict certain products,and its decisions are often shaped by the advisory committee. Whether it will take any actions soon is unclear. The committee is meeting Friday in closed session to discuss product information classified as trade secrets.
The Environmental Protection Agency is scheduled to reregister triclosan in September 2007 and will begin assessing data regarding the potentially adverse chemical late next year.