Antibacterial agents

In its broadest sense, an antibacterial is an agent that destroys bacteria or interferes with their growth and reproduction. While antibiotics and antibacterials both fight bacteria, the terms refer to related categories, with antibiotics representing a type of antibacterial agent used to treat disease. Antibiotics are used in medicine to fight disease. Antibacterials are primarily used to disinfect surfaces and eliminate potentially harmful bacteria. Antibacterial agents are found in consumer products such as soap, detergents, skin care products, and household cleansers. While no evidence exists indicating that the routine use of antibacterial agents provides a health benefit, the agents have demonstrated proven efficacy for killing bacteria. As a result, antibacterials can be helpful when sanitation is critical to prevent the spread of disease, such as in hospitals, day care centers, and other environments with higher concentrations of infectious bacteria.

Overview

Antibacterials are divided into two groups based on how fast they work and how much residue they produce. The first group is referred to as non-residue-producing and includes fast-acting antibacterial agents that leave no active residue behind. Examples include alcohols, chlorines, and peroxides, which have been used for decades in both health care settings and household cleaning products. The second group, residue-producing antibacterials, is made up of commonly used compounds, such as triclosan and benzalkonium chloride, which have slower but longer effectiveness as a result of long-acting residue that lingers on the surface being disinfected. Once used exclusively in health care settings, agents in the second group have become widely used in household soaps and cleaning products since the year 2000. In 2016, the US Food and Drug Administration issued a final rule providing that certain active ingredients used in over-the-counter consumer antiseptic wash products, including triclosan and triclocarban, are not generally recognized as safe and effective for that use. One advance has been the bonding of triclosan to the surface of many high-use consumer products, such as kitchen utensils, toys, and even bedding, to provide built-in antibacterial protection.

Non-residue-producing antibacterials have been used effectively for many years to help control the proliferation of disease organisms in health care settings. When used appropriately, residue-producing antibacterial agents also have demonstrated results for controlling bacterial and fungal infections in clinical settings such as hospitals, nursing homes, and newborn nurseries. However, there is no evidence to suggest that antibacterial agents used in consumer products, such as toothpaste, deodorant, and shampoo, provide a health benefit.

Some experts say that antibacterial agents actually may be detrimental to health if they are used in place of normal hygiene habits. Excessive use of antibacterials can also destroy beneficial bacteria and open the door for disease-causing bacteria to take hold and cause disease. In addition, long-term use of residue-producing antibacterial agents, even at low concentrations, may increase the risk of bacterial resistance and lower the effectiveness of the active agent.

Depending on their intended use, antibacterial agents may be subject to regulation by the US Food and Drug Administration (FDA). Antibacterial soaps and antibacterial substances that are intended for use on the human body or are involved in food processing in any way are subject to FDA regulation. Antibacterial agents with other uses must be registered with the US Environmental Protection Agency either as a nonpublic health antimicrobial agent or as a public health antimicrobial agent, a category that includes sanitizers, disinfectants, and sterilizers.

The COVID-19 pandemic that began in 2020 led to a profound increase in the use of antibacterial agents, most notably hand sanitizers. World Health Organization (WHO) reporting on hospitalized COVID-19 patients found that bacterial coinfections were identified in a small minority of cases, even though antibiotics were administered to many patients. A policy brief published by the Pan American Health Organization examined the impact that the increased use of antibacterial agents had on bacterial resistance (referred to as antimicrobial resistance in the brief) and concluded that COVID-19-related antibacterial use has contributed to an increase in antimicrobial resistance, which thus worsened the treatment of other bacterial infections treated with antibiotics. The brief, which cited estimates that antimicrobial resistance will cause ten million deaths a year by 2050, urged a reduction in the use of antibacterial agents in order to reduce and prevent further increases in antimicrobial resistance. More broadly, global public health guidance has characterized antimicrobial resistance as a major health and development threat and has promoted a One Health approach that addresses human, animal, and environmental drivers of resistance.

Bibliography

Aminov, Rustam I. “A Brief History of the Antibiotic Era: Lessons Learned and Challenges for the Future.” Frontiers in Microbiology, vol. 1, no. 134, 8 Dec. 2010. doi:10.3389/fmicb.2010.00134. Accessed 8 Mar. 2026.

Amyes, Sebastian G. B. Bacteria: A Very Short Introduction. Oxford UP, 2013.

Anderson, Rosaleen, Paul Groundwater, Adam Todd, and Alan Worsley. Antibacterial Agents: Chemistry, Mode of Action, Mechanisms of Resistance and Clinical Applications. Wiley, 2012.

“Antimicrobial Resistance, Fueled by the COVID-19 Pandemic: Policy Brief Nov. 2021.” Pan American Health Organization, 2022. . Accessed 8 Mar. 2026.

“Antimicrobial Resistance.” World Health Organization (WHO), 21 Nov. 2023,
. Accessed 8 Mar. 2026.

DiMartino, Patrick. "Antimicrobial Agents and Microbial Ecology." AIMS Microbiology, vol. 8, no. 1, Jan. 2022, pp. 1–4, doi:10.3934/microbiol.2022001. Accessed 8 Mar. 2026.

Food and Drug Administration. “Safety and Effectiveness of Consumer Antiseptics; Topical Antimicrobial Drug Products for Over-the-Counter Human Use.” Federal Register, vol. 81, no. 172, 6 Sept. 2016, pp. 61106–61130.
. Accessed 8 Mar. 2026.

Mascaretti, Oreste A. Bacteria Versus Antibacterial Agents: An Integrated Approach. ASM Press, 2003.

Miller, Alita A., and Paul F. Miller. Emerging Trends in Antibacterial Discovery: Answering the Call to Arms. Caister Academic Press, 2011.

"Science of Resistance: Antibacterial Agents." Alliance for the Prudent Use of Antibiotics, 2023, apua.org/antibacterial-agents. Accessed 8 Mar. 2026.

Skold, Ola. Antibiotics and Antibiotic Resistance. Wiley, 2012.

“WHO Reports Widespread Overuse of Antibiotics in Patients Hospitalized with COVID-19.” World Health Organization, 26 Apr. 2024,
. Accessed 8 Mar. 2026.

Wilson, Michael, Rod McNab, and Brian Henderson. Bacterial Disease Mechanisms: An Introduction to Cellular Microbiology. Cambridge UP, 2002.