Effect of the Quantity of Alcohol-based Hand Rub and Fingertip Rubbing on Bacterial Elimination

Antiseptic hand rub is recommended in medical facilities. However, it is reported that staff frequently use less than the recommended quantity of alcohol-based hand rub when washing their hands. Furthermore, the hand rub is often not rubbed into the fingertips. The aim of this study was to verify whether there is a significant difference in the bacterial elimination effect according to the quantity of the hand rub used and also if the degree of thoroughness in rubbing the hand rub into the fingertips makes a significant difference or not. Participants were divided into fingertips rubbing groups and fingertips non-rubbing groups. Each group did a antiseptic hand rub using both the standard quantity (3 mL) and half the standard quantity (1.5 mL) of alcohol-based hand rub. The numbers of bacteria on the fingertips, fingers and palms were counted using the agar stamp method before and after the hand rub. In the fingertips non-rubbing group, the bacterial elimination rate ON the fingertips was significantly lower compared to the fingers and palms (both 3 mL and 1.5 mL p< 0.001). Also the log10 reduction of the fingertips was significantly lower in the non-rubbing group compared to the fingertips rubbing group (3 mL p < 0.01, 1.5 mL p < 0.001). Furthermore, in the fingertips non-rubbing group, the log₁₀ reduction of the fingertips was significantly lower when 1.5 mL of hand rub was used than when 3 mL of hand rub was used (p < 0.01). There was no difference in the bacterial elimination effect between the fingers and palms according to the quantity of hand rub or whether the hand rub was used on the fingertips. Furthermore it is necessary to recognize that the bacterial elimination effect will decrease if the quantity of hand rub used is less than half the recommended quantity.