For over a decade, pharmaceutical industries have been funding research on infection control to test the efficacy of its antibacterial wipes. Such relationships are prevalent in the infection-control business.

Nonetheless, many health experts believe that industry funding of chlorhexidine research by companies such as Sage Products has muddied the initial purpose. The safety and effectiveness of chlorhexidine wipes are overlooked as the demand of the products increases, according to experts.

“We know antibiotic-resistant infections are out of control. We need something that works,” said Martin Blaser, a professor in New York University’s Department of Microbiology and chair of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria.

Overuse may trigger antibiotic resistance

At Rush University Medical Centre in Chicago, researchers were funded by Sage Products to test the efficacy of wipes soaked with chlorhexidine, a strong antibacterial chemical. In 2006, the study was published confirming its efficacy on hospital patients, which led to Food and Drug Administration (FDA) approval of the wipes for cleansing of skin before surgery.

Sage Products have since backed research for Dr Robert A. Weinstein, an infectious-disease specialist at Rush and the lead researcher of the studies, and his colleagues, who have recommended “off-label” use for daily washing of patients with the patented wipes following several trials.

The use of chlorhexidine products has now become more common in hospitals and other healthcare settings where drug-resistant “superbugs” are a chronic issue. In 2014, a survey by the federal Centres for Disease Control and Prevention (CDC) found 63% of hospitals routinely bathed patients with chlorhexidine.

However, it is still impossible to tell whether washing patients daily with such a potent biocide is wise or effective, according to Blaser. He says that indiscriminate use could trigger resistance in harmful bugs or kill off beneficial bacteria, with dangerous consequences.

Results from studies contradict infection rates

The promising results from these industry-funded studies are in contrast to the rates of hospital acquired drug-resistant infections in the US. In fact, the Centres for Disease Control and Prevention (CDC) has labelled more than a dozen superbugs that threaten the public health and lead to infections.

The potential risks of chlorhexidine were uncovered when the FDA issued a warning in February this year following reports of allergic reaction, death cases and other adverse events associated with the chemical. A study by researchers at Cardiff University also revealed that the use of wet wipes spreads hospital superbugs from one surface to another.

In addition, Sage Products were forced to recall their products in 2008 and last year due to pathogen infection found on chlorhexidine cloths. An article published in 2013, co-written by Weinstein, explained that the 2008 recall was due to “treatment interruption”, and concluded that the wipes were safe and effective without mentioning the infections.

Recent research study receives criticism

Research is still continuing to be funded by the industry in the absence of government funding. One of the most recent studies led by Weinstein investigated whether daily bathing of all adult intensive care unit patients with the chlorhexidine wipes would reduce the superbug methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections.

Although the study stated daily wipedowns reduced infections by 44%, there were many controversies to its data and results. The study was said to inadequately document the advantages of daily chlorhexidine use or its risks.

“It really doesn’t make the case,” said Dr Kevin Kavanagh, a patient safety researcher who published his criticisms in a 2013 article. “When you look at data, the vast majority of the effect on preventing infections was on the more benign skin bacteria and yeast.”

However, Weinstein dismissed the criticism, saying that many studies prove that chlorhexidine works and many people are benefiting from the reduced risk of infections.

“As long as people are benefiting…you use it,” Weinstein said. “If resistance emerges, well, maybe there'll be a new product.” MIMS

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