Hand sanitisers amid CoViD-19: A critical review of alcohol-based products on the market and formulation approaches to respond to increasing demand

Abstract

The world is facing a medical crisis amid the CoViD-19 pandemic and the role of adequate hygiene and hand sanitisers is inevitable in controlling the spread of infection in public places and healthcare institutions. There has been a great surge in demand for hand sanitisation products leading to shortages in their supply. A consequent increase of substandard products in the market has raised safety concerns. This article, therefore, presents a critical review of hand sanitation approaches and products available on the market in light of the scientific evidence available to date. This review also provides a range of hand sanitisation product formulations, and manufacturing instructions to allow for extemporaneous preparations at the community and hospital pharmacies during this urgent crisis. In addition, this emergent situation is expected to continue, hence hand sanitisers will be in demand for an extended time, and the availability and purchase of substandard products on the market create an ongoing safety concern. Therefore, this article shall also provide various commercial organisations, interested in stepping forward the production and marketing of hand sanitisers, with a guide on the development of products of standardised ingredients and formulations.

In vitroassessment of the virucidal activity of four mouthwashes containing Cetylpyridinium Chloride, ethanol, zinc and a mix of enzyme and proteins against a human coronavirus

“…Though preliminary, this result agrees with evidence of CPC activity against influenza virus and a recently published clinical trial with COVID-19 patients, where a 0.075% CPC containing mouthwash was reported to reduce saliva viral load for up to 6 hours after use 9,14 . Contact with the mouthwash containing 15.7% ethanol did not lead to significant reduction in count, and given alcohol levels of 60% -95% v/v are used in hand hygiene products, it seems likely that a mouthwash will require a higher concentration of ethanol or combination of agents to bring about a reduction in viral load 15 . Under the conditions of this test, mouthwashes with zinc and the enzyme and proteins mix did not substantively impact viral count, however, these agents are reported to have viricidal action and merit further study.…”

Assessing severe acute respiratory coronavirus virus 2 (SARS-CoV-2) preparedness in US community hospitals: A forgotten entity

“…Although some data exist on the safety of reprocessed N95 respirators, safety data on reuse of other single use PPE are scarce. 9 Shortages of disinfectants and sanitizers may lead to the introduction of new agents with a potential decrease in cleaning efficiency, variation in equipment compatibility, an increase in staff dissatisfaction, and occupational safety hazards. 9 Our survey also demonstrates that most of our community hospitals had implemented policies related to employee screening at the point of hospital entry.…”

Alcohol-Based Hand Sanitizers – A Multidimensional Perspective

“…Isopropanol is more effective against bacteria while ethanol is favorably virucidal, which may be due to differences in polarity [5]. [8].…”

“…Many countries have specific regulations that govern the production of ABHS [34]. In Europe, ABHS are regulated under the Biocidal Products Regulation [8,35]. In the United States, ABHS are regulated as a drug products by the FDA.…”