Should I Use Antibacterial Wipes?
I have a patient who is asking to use antibacterial wipes instead of alcohol wipes to cleanse the skin. What would be your recommendation? DeLaura White, RN, BSN, Frederick, Maryland
Christy L. Parkin, MSN, RN, CDE, responds
Antibacterial agents are everywhere these days,including in soaps, hand sanitizers, hygiene towelettes, and germ-killing products.
What to Know
The main concern regarding antibacterial wipes on the skin is that many of these sanitizers contain ingredients such as benzalkonium chloride that can irritate the skin. The American Medical Association discourages the use of antibacterial agents in consumer products because regular use may encourage the development of superbugs, which are antibiotic-resistant bacteria.
Antibacterial products are risky for people with diabetes in particular: Using them (usually the scented variety) before blood glucose testing may lead to an incorrect reading.
The other option is an alcohol wipe. In a hospital or clinical setting, the normal protocol is to swab the injection or testing site with an alcohol wipe because of the higher risk of infection from sick people. This practice often carries over after a person returns home. Because most Medicare Part D and Medicaid plans continue to cover alcohol pads, and because syringe and pen needle companies include alcohol wipes in their patient education materials, many people believe that it is necessary to continue to swab the skin before injection. And many experts still advise patients to use an alcohol wipe before blood glucose testing.
Just as diabetes management has changed over the years to make life a little easier and more convenient, so have some of our tried-and-true diabetes management practices. Several studies have reported that there is no increased risk of infection from single-use syringes, pen needles, or lancets when alcohol swabs are not used. Most current practice guidelines, including those from the American Association of Diabetes Educators, no longer recommend the use of alcohol swabs, which can lead to dry skin. If an injection needs to be given or testing must be done under unusual circumstances (such as with dirty or sweaty skin where soap and water are unavailable), clean the area with alcohol.
Usually it is not necessary to swab with alcohol or disinfectant wipes before testing blood glucose or injecting insulin. It is best to use soap (not antibacterial) and water to cleanse the skin.
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