Dear Dr. Roach: I am a dedicated reader of your column and appreciate very much your attention to detail. I was surprised to read in my local paper recently that you recommend hand sanitizer over hand-washing with soap and water. This is contrary to all other health advice I have seen. Please explain. I do understand using it when one cannot use soap and water. — A.B.
Answer: I don’t think I explained that very well, as several people have written to me with the same question. Hand-washing with soap and water is preferred for many or most situations. However, in the hospital, when health care workers need to perform hand hygiene many times daily, alcohol-based hand sanitizer may be preferred because compliance is higher with it and because it is much faster.
There are some situations where hand sanitizer should not be used and hands should be washed with soap and water: when hands are visibly soiled; when they start feeling “sticky”; and in the cases of some infections, especially C. difficile and norovirus.
In all cases, hands should be washed after using the bathroom, and before and after eating.
