Antibacterial agents
Antibacterial agents are substances designed to destroy bacteria or inhibit their growth and reproduction. They are distinct from antibiotics, which are specifically used in medicine to treat bacterial infections. Antibacterial agents are commonly found in various consumer products, including soaps, detergents, and household cleaners, and are especially crucial in environments like hospitals and day care centers where sanitation is paramount. These agents are categorized into two groups: non-residue-producing antibacterials, such as alcohol and chlorine, which act quickly and leave no residue; and residue-producing antibacterials, like triclosan and benzalkonium chloride, which have a slower action but leave persistent antimicrobial effects. While these agents are effective in controlling harmful bacteria, their routine use in everyday products may not offer health benefits and could potentially disrupt the balance of beneficial bacteria. Additionally, overuse of antibacterials raises concerns about bacterial resistance, which can complicate both treatment and prevention of infections. The COVID-19 pandemic significantly increased the use of antibacterial agents, leading to discussions on their role in promoting antimicrobial resistance, highlighting the need for careful regulation and usage.
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Subject Terms
Antibacterial agents
In its broadest sense, an antibacterial is an agent that destroys bacteria or interferes with its growth and reproduction. While antibiotics and antibacterials both fight bacteria, the two terms describe separate purposes. Antibiotics are used in medicine to fight disease. Antibacterials primarily are used to disinfect surfaces and eliminate potentially harmful bacteria. Antibacterial agents are found in consumer products such as soap, detergent, skin care products, and household cleansers. While no evidence exists indicating that the routine use of antibacterial agents provides a health benefit, the agents have demonstrated proven efficacy for killing bacteria. As a result, antibacterials can be helpful when sanitation is critical to prevent the spread of disease, such as in hospitals, day care centers, and other environments with higher concentrations of infectious bacteria.
Overview
Antibacterials are divided into two groups based on how fast they work and how much residue they produce. The first group is referred to as non-residue-producing and includes fast-acting antibacterial agents that leave no active residue behind. Examples include alcohols, chlorines, and peroxides, which have been used for decades in both health care settings and household cleaning products. The second group, residue-producing antibacterials, is made up of newer types of compounds, such as triclosan and benzalkonium chloride, which have slower but longer effectiveness as a result of long-acting residue that lingers on the surface being disinfected. Once used exclusively in health care settings, agents in the second group have become widely used in household soaps and cleaning products since 2000. One advance has been the bonding application of triclosan into the surface of many high-use consumer products, such as kitchen utensils, toys, and even bedding, to provide built-in antibacterial protection.
Non-residue-producing antibacterials have been used effectively for many years to help control the proliferation of disease organisms in health care settings. When used appropriately, residue-producing antibacterial agents also have demonstrated results for controlling bacterial and fungal infections in clinical settings such as hospitals, nursing homes, and newborn nurseries. However, there is no evidence to suggest that antibacterial agents used in consumer products, such as toothpaste, deodorant, and shampoo, provide a health benefit.
Some experts say that antibacterial agents actually may be detrimental to health if they are used in place of normal hygiene habits. Excessive use of antibacterials also can destroy beneficial bacteria and open the door for disease-causing bacteria to take hold and cause disease. In addition, long-term use of residue-producing antibacterial agents, even at low concentrations, may increase the risk of bacterial resistance and lower the effectiveness of the active agent.
Depending on their intended use, antibacterial agents may be subject to regulation by the US Food and Drug Administration (FDA). Antibacterial soaps and antibacterial substances that are intended for use on the human body or are involved in food processing in any way are subject to FDA regulation. Antibacterial agents with other uses must be registered with the US Environmental Protection Agency either as a non–public health antimicrobial agent or as a public health antimicrobial agent, a category that includes sanitizers, disinfectants, and sterilizers.
The COVID-19 pandemic that began in 2020 led to a profound increase in the use of antibacterial agents, most notably hand sanitizers. A policy brief published by the Pan American Health Organization examined the impact that the increased use of antibacterial agents had on bacterial resistance (referred to as antimicrobial resistance in the brief) and concluded that COVID-19-related antibacterial use has directly led to an increase in antimicrobial resistance, which thus led to the worsening of treatment of both conditions treated with antibiotics and COVID-19 (due to compromised immune systems that result from reduced effectiveness in treating the former). The brief, which estimated that antimicrobial resistance will cause 10 million deaths a year by 2050, urged for a reduction in the use of antibacterial agents in order to reduce and prevent further increases in antimicrobial resistance.
Bibliography
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