BACKGROUND: Alcohol-based hand rubs (ABHRs) are the primary method of hand 
hygiene in health-care settings. ICPs increasingly are assessing ABHR product 
efficacy data as improved products and test methods are developed. As a result, 
ICPs need better tools and recommendations for how to assess and compare ABHRs.
METHODS: Two ABHRs (70% ethanol) were tested according to 3 in vivo methods 
approved by ASTM International: E1174, E2755, and E2784. Log10 reductions were 
measured after a single test product use and after 10 consecutive uses at an 
application volume of 2 mL.
RESULTS: The test method used had a significant influence on ABHR efficacy; 
however, in this study the test product (gel or foam) did not significantly 
influence efficacy. In addition, for all test methods, log10 reductions obtained 
after a single application were not predictive of results after 10 applications.
CONCLUSIONS: Choice of test method can significantly influence efficacy results. 
Therefore, when assessing antimicrobial efficacy data of hand hygiene products, 
ICPs should pay close attention to the test method used, and ensure that product 
comparisons are made head to head in the same study using the same test 
methodology.