A few weeks ago as I was walking out of a Harris Teeter grocery store in Raleigh, North Carolina, I saw a man face a moment of crisis. You could see it in the acrobatic contortions of his face. He had pulled a cart out of the area where carts congregate, only to find that its handle was sticky with an unidentifiable substance. He paused and looked at the handle, as if to imagine the nature of the offense. Gum? Meat juice? Chewed marshmallows? So many vulgar possibilities. Forlorn, he reached for an antibiotic wipe conveniently placed by the door. He scrubbed his hands VERY diligently and then pushed the cart back for someone else to rediscover [1].
Scenarios like this one are playing out all over America. There is an epidemic of sticky, dirty and otherwise gross handles on shopping carts. But it isn't just carts. Disgusting doorknobs have also been found, as have cryptically damp table-tops in restaurants and even, sad as it is, slimy back rests on the weight machines in gyms! Increasingly, the world seems to be rife with contamination. Fortunately, all of the main companies producing hygiene products have offered a solution--sanitary, antibacterial, antimicrobial, antibiotic, wipes, and soaps to kill anything that dares to creep into our wholesome lives. These salves will cure us of the demons that dare to grow near us.
The really intriguing news--a kind of breakthrough--is that the main compounds in antibiotic wipes, creams and soaps, triclosan and/or the chemically similar triclocarban, have also been sprinkled around our lives more generally. A recent study notes that triclosan is now used to "impregnate surfaces and has been added to chopping boards, refrigerators, plastic lunchboxes, mattresses as well as being used in industrial settings, such as food processing plants where walls, floors and exposed machinery have all been treated with triclosan in order to reduce microbial load." You can now go home, wipe your world down and live a happier life, surrounded by an antibiotic force field. Be especially sure to wipe your children down. Children are just about the grimiest thing in the world.Yet, although I hesitate to digress or cause trouble, the devil on my shoulder, that voice of so-called reason, is urging me to avail myself of more than the vague suspicion that everything around me is contaminated. Maybe, the devil says, we should glance, just for a second, at what scientists like to call--in their nasally ivory-tower voices--"the evidence." I do not mean anything too fancy… Let's just take a moment to look at a study here and there that might be relevant as we go about coating our lives--from underpants to kitchen pans--in antibiotic wonder.
For example, what if we just considered whether people who wipe down the world around them with antibiotic soap or wipes are less likely to be sick. Of course, they must be. The world is gross and they are, God bless them, clean, but let's just check.
OK, we shouldn't have checked. There are some problems. One is the actual evidence, or just as often, lack thereof. Case in point: along with her colleagues, Allison Aiello, a professor at the University of Michigan, recently surveyed all of the experimental or quasi-experimental studies published in English between 1980 and 2006 on the effectiveness of different hand washing strategies [2]. Aiello focused on studies that compared different strategies, for example the use of normal soap versus the use of antibiotic soap, in terms of their effect on the probability of developing gastrointestinal or respiratory illness. Our intuition is that antibiotic soaps and wipes should make everyone healthier. Aiello's results were something else entirely.
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