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Efficacy of an alcohol/chlorhexidine hand hygiene program in a hospital with high rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection

Paul D R Johnson and M Lindsay Grayson
Med J Aust 2006; 184 (5): . || doi: 10.5694/j.1326-5377.2006.tb00223.x
Published online: 6 March 2006

In reply: Woollard is critical of the lack of randomised controlled data to support the use of alcohol/chlorhexidine hand rub solution (ACHRS). Although a placebo-controlled study would be ideal, it is doubtful whether one could be performed. Apart from the complexity of design and cost, there would be the requirement to ask patients to consent to being treated in a hospital where there was a substantial risk of nosocomial sepsis, but where half the health care workers would not have clean hands when attending them.


  • Infectious Diseases Department, Austin Health, Studley Road, Heidelberg, VIC 3084.


Correspondence: paul.johnson@austin.org.au

  • 1. Graham M, Nixon R, Burrell LJ, et al. Low rates of cutaneous adverse reactions to alcohol-based hand hygiene solution during prolonged use in a large teaching hospital. Antimicrob Agents Chemother 2005; 49: 4404-4405.<eMJA full text>
  • 2. McBryde ES, Bradley LC, Whitby M, McElwain DL. An investigation of contact transmission of methicillin-resistant Staphylococcus aureus. J Hosp Infect 2004; 58: 104-108.
  • 3. Pessoa-Silva CL, Dharan S, Hugonnet S, et al. Dynamics of bacterial hand contamination during routine neonatal care. Infect Control Hosp Epidemiol 2004; 25: 187-188.

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