Poor home hygiene contributing to antibiotic resistance, warn global hygiene experts

According to the Global Hygiene Council's (GHC) public health experts, following a risk-based approach to home hygiene is essential to curbing the growing threat of antibiotic resistance.

It is estimated that rates of resistance to commonly used antibiotics could exceed 40 to 60% in some countries by 2030. With AMR set to claim the lives of 10 million by 2050 if no action is taken, the GHC's experts are calling for a review of hygiene practices in homes and everyday life to ensure that they are effective and appropriate to the urgent public health issues we currently face, such as AMR and COVID-19.

In a new Position Paper developed by the GHC and published in the latest edition of the American Journal of Infection Control, the experts set out the evidence showing that better hygiene in our homes and everyday lives plays an essential part in tackling antibiotic resistance. Good hygiene contributes to the fight against AMR in two ways, by preventing infection, thereby reducing the need for antibiotic prescribing and preventing person to person spread of infections which are antibiotic resistant.

The paper reviews evidence that to minimize the spread of infections in home and community settings, a more focused approach to hygiene based on risk assessment is needed. For example, removing infection-spreading germs from high-risk surfaces and hands at critical times, such as when preparing food and using the toilet, has been proven to minimize the spread of infections from person to person. One intervention study demonstrates that improved hand hygiene amongst a group of children in a day center can reduce the need for antibiotic use for common respiratory infections by 30%.

Professor Sally Bloomfield, public health expert and contributor to the paper, says, "Instead of deep-cleaning our homes, we urge everyone to maintain this evidence-based targeted hygiene approach in our homes and everyday lives, focusing on the times and places harmful microbes are most likely to spread, to not only help contain the spread of coronavirus now but ongoing to help tackle AMR."

To coincide with the publication of the Paper, the GHC has launched a manifesto calling upon national and international policy makers, health agencies and healthcare professionals to further recognize the importance of hygiene in the home and everyday life settings and acknowledge the following:

1. National AMR committees, responsible for implementing national AMR plans, should recognize that improved hand and surface hygiene in the home and community are key to minimize the spread of infections and as a consequence the consumption of antibiotics, which will then help in the fight against AMR. To achieve this, recommendations for improved hygiene in the wider community should be included in global AMR action plans by 2022 and in all national plans by 2025.
2. IPC advice, guidance and education for HCPs on hand and surface hygiene and its relation to AMR should not be limited to healthcare settings, but also include recommendations to influence the wider community with immediate effect.
3. Relevant medical associations should ensure messaging around home and community hygiene is cascaded to members through amending on-going and existing AMR training and education.

With evidence to show that home and community hygiene urgently needs to be taken more seriously, it is time for the global community to collaborate and recognize that reducing the need for antibiotic prescribing and the circulation of AMR strains in healthcare settings cannot be achieved without also reducing the circulation of infections and AMR strains in the community.