Journalist and author of the book The War on Bacteria
I look forward to FHI advising against daily use of hand alcohol outside the health institutions.
This is a debate post. Opinions in the text are at the writer’s expense.
“There is little indication that hand alcohol is the reason why antibiotic resistance is a growing problem in the world,” writes the National Institute of Public Health (NIPH) in a reply to me on 16 December. I agree with that.
In my book “The war against bacteria” it is clearly documented that it is overuse and misuse of antibiotics, not least in European animal husbandry, that drives increasing resistance to antibiotics.
It is therefore perceived as a bit strange that FHI tries to impose on me opinions I have never advocated rather than discussing the question I have raised: namely whether bacteria can also develop increasing tolerance for alcohols and hand alcohol?
If bacteria become more tolerant of hand alcohol, it is alarming. For such alcohols is an important means of combating antibiotic resistance. In the event of an outbreak of resistant bacteria, hand sanitizer and alcohol-based detergents are crucial to prevent the spread between departments.
FHI tries to impose on me opinions I have never defended
I notice that FHI now agrees with me that bacteria can develop more tolerance for such alcohols, among other things by developing thicker cell walls.
And here lies the problem. For this is not at all just a theoretical problem. The strategy the bacteria use to fight certain types of antibiotics is the same in that they can change the so-called permeability of the cell wall.
I am therefore pleased that FHI finally admits that this is an opportunity. I have already received support from Professor Olav Vadstein, without FHI having found room to comment on it.
Develops higher tolerance
The professional basis is thus in place for a stricter regulation of the use of alcohol. Because even though the bacteria’s ability to adapt to alcohols is incremental, one must have a long-term perspective in mind here. If the hand sanitizer is used correctly and in sufficiently high doses, the bacteria die, FHI points out. I agree with that.
But not everyone uses rubbing alcohol correctly. The shops have dispensers that give too small doses, and hand alcohol products are sold in Norway with concentrations down to 60 percent alcohol.
I also do not think it is good that children and adults use hand alcohol daily to kill the normal flora on their hands
Over time, this allows the bacteria to develop higher tolerance to alcohols. I also do not think it is good that children and adults use hand alcohol daily to kill the normal flora on their hands. Good bacteria protect against disease and are important for building children’s immune system. I am therefore glad that FHI clearly writes that soap and water should be the “first choice”, not hand alcohol.
I look forward to FHI in the future taking the consequences of this reasoning and discouraging daily use of hand alcohol outside the health institutions.