Monday, December 30, 2013

The FDA Rolls Its Eyes with Exasperation at Triclosan in Anti-Bacterial Products

In August, we talked about triclosan, an anti-bacterial agent, and its potential not-so-pleasant environmental effects. The FDA has now proposed a new rule requiring manufacturers to prove that products containing triclosan are more effective than simple soap and water.

As a quick reminder, triclosan works by binding to the enoyl-acyl carrier protein reductase (ENR) and increasing its affinity for a co-enzyme. When ENR is clogged up, the bacteria is unable to create cell membranes. Since cell membranes are kinda important, the bacteria subsequently dies.

However, the fact that there is a mechanism by which triclosan is capable of killing bacteria does not indicate that triclosan provides a meaningful benefit over safe, environmentally-friendly alternatives. According to the FDA website, "For... consumer products [other than toothpaste, the] FDA has not received evidence that the triclosan provides an extra benefit to health. At this time, the agency does not have evidence that triclosan in antibacterial soaps and body washes provides any benefit over washing with regular soap and water."

Source: http://www.fda.gov/forconsumers/consumerupdates/ucm205999.htm
Dr. Sandra Kweder, deputy director of the Office of New Drugs in the FDA's Center for Drug Evaluation and Research, added, "Our goal is, if a company is making a claim that something is antibacterial and in this case promoting the concept that consumers who use these products can prevent the spread of germs, then there ought to be data behind that." (A-fucking-men!)

The new rule would also require that manufacturers to provide additional safety data in order for triclosan to be considered "generally recognized as safe for use". Most concerning is the possibility that antibacterial agents like triclosan will contribute to bacterial resistance. When subpopulations of a larger bacterial population survive a dose of antibiotics, the remaining organisms are more likely to have antibacterial-resistant genes. Since these genes are highly likely to exist on plasmids, small DNA molecules that are separate from the cell's chromosomal DNA, these genes can actually be passed from bacteria to bacteria in a process called horizontal gene transfer. This means that if a single bacterial species develops antibacterial resistance, it can actually be passed from species to species.

As antibacterial agents become more commonly used, there is increased selective pressure on bacterial species. Thus, resistance evolves to become more and more common. If your hospital is relying on antibacterials like triclosan to keep patients safe, but every Tom, Dick, and Harry is using triclosan in their hand soap, this is a big concern. (The proposed rule would exempt hand sanitizers, hand wipes, and antibacterial soaps that are used in health care settings.)

The FDA is currently waiting as both consumers and experts weigh in on their triclosan-related opinions. In the meantime, don't forget to wash your hands.

14 comments:

  1. I had thought the FDA's concern with triclosan wasn't so much about creating drug-resistant bacteria strains as it was that it was an endocrine disruptor? Although I suppose that the one doesn't preclude the other! mmmm, MRSA *and* gynecomastia!

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    1. The FDA identified a couple of potential health risks. I probably should have been more clear that I was editorializing when I suggested that antibacterial resistance was "most concerning"!

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    2. Don't get me wrong -- either of those is a super big deal! The whole thing sounds like a horrible game of "Would You Rather."

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    1. It's just all so complicated and horrible and it takes so long for things to get done

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  3. My face does twitch a bit when I see the latest 'protect your family with this unnecessarily hardcore antibacterial soap!' ad or product. Just. Use. Soap. You only need hospital grade disinfectants in hospitals. Hence the name!

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    1. Regular old soap is a wonderful thing!

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  4. I can't believe I saw this too late! I bought three bottles of hand wash at Bath & Body Works two weeks ago and neglected to see that they all claim to be "antibacterial". Sometimes their smell is blinding.

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  5. I have such a mixed opinion about Triclosan. On the one hand yes, I absolutely see the scientific fact that everyone using antibacterial ingredients for EVERYTHING both builds bacterial resistance. But I'm on Humira (an auto-immune drug). The point of the medication (much like methotrexate for example) is to lower your immunes system. The side effect is that little infections you normally fight off no problem peek out. Aaand for me that means mouth sores. The only quick and dirty not prescription fix I've found is to use Colgate Total toothpaste because it has Triclosan. But I guess this is a case where we want to save the antibacterial effect for when it's needed...I'm just the silly sucker that does. Just pointing out I hate to see it removed from Total, if they do I'm on to prescription somethingorother.

    In other news, love your tone, think it's genius, you're my blogmentor (I'm the dork at spinthemailbox.com).

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  6. I love Dial soap with Triclosan. It's harmless. It's the only soap that keeps me fresh longer and has actually healed me of very minor things on my skin like keratosis pilaris on my arms. It also keeps my ass---e as clean as absolutely possible. It also prevents back acne. It's good stuff! And has been for very many years.

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  7. I like good old fashioned Dr.Bronner's, personally. It's does double duty; cleaning my makeup brushes & my hands.

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