Sanitizer
Hand sanitizer is a liquid or gel generally used to decrease infectious agents on the hands.[3] Formulations of the alcohol-based type are preferable to hand washing with soap and water in most situations in the healthcare setting.[4][5] It is generally more effective at killing microorganisms and better tolerated than soap and water.[6] Hand washing should still be carried out if contamination can be seen or following the use of the toilet.[7] The general use of non-alcohol based versions has no recommendations.[4] Outside the health care setting, hand washing is generally preferred.[8][9][10] They are also less effective for microorganisms norovirus, and Clostridium difficile.[8] They are available as liquids, gels, and foams.[6]
Alcohol-based versions typically contain some combination of isopropyl alcohol, ethanol (ethyl alcohol), or n-propanol.[6] Versions that contain 60 to 95% alcohol are most effective.[6] Care should be taken as they are flammable.[4] Alcohol-based hand sanitizer works against a variety of microorganisms but not spores.[6] Some versions contain compounds such as glycerol to prevent drying of the skin.[6] Non-alcohol based versions may contain benzalkonium chloride or triclosan.[11][12]
Alcohol has been used as an antiseptic at least as early as 1363 with evidence to support its use becoming available in the late 1800s.[13] Alcohol-based hand sanitizer has been commonly used in Europe since at least the 1980s.[14] The alcohol-based version is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system.[15] The wholesale cost in the developing world is about US$1.40–3.70 per liter bottle
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