CDC to recommend use of alcohol-based rubs. (Cuts Infections, Less Irritating than Soap).

SAN DIEGO -- "Rub-a-dub-dub" is about to take on a whole new meaning for U.S. health care workers.

New guidelines on hand hygiene to be released this fall by the Centers for Disease Control and Prevention will promote the use of alcohol-based "rubs" that can be slathered onto the hands in lieu of washing, Dr. John M. Boyce said at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy.

Federal officials hope that dismal rates of compliance with hand-hygiene guidelines last produced by the CDC in 1985 and by other organizations in 1988 and 1995 will improve with the convenience and user friendliness of the alcohol-based rubs. A 1999 study found, for example, that only 30% of physicians and 52% of nurses complied with hand-washing recommendations.

"We haven't made any progress in improving compliance in the last 20 years," said Dr. Boyce, coauthor of the new guidelines and chief of infectious diseases at the Hospital of St. Raphael in New Haven.

The new recommendations will apply to all health care settings, not just hospitals.

Four recent studies have shown that promoting alcohol-based rubs and educating health care workers on their use can improve compliance with hygiene guidelines, he said. In 22 published studies comparing the antibacterial efficacy of various hand-hygiene products, products containing alcohol or a combination of alcohol and chlorhexidine came out on top in every study Washing with soap and water was the least effective method in nearly every study.

A variety of alcohol-based foams, gels, or lotions are available on the market; they have been the standard for hand hygiene in some European countries for years. Some of the products are available in packets that fit in coat pockets; others are pumped from dispensers attached to walls. A quarter-size dollop can disinfect hands in 15 seconds or less, compared with a minute or more typically required with traditional hand washing.