The Rub Is Rubbish

For generations the quick, routine swipe with an antiseptic swab has been the accepted procedure before every medical injection. But is it necessary, or even effective? Neither, says Dr. Thomas Charles Dann, medical officer of the University College of Swansea in Wales. The usual, perfunctory five-second swabbing of the skin is far too brief for any of the antiseptics used to sterilize the area. As proof that this "routine rub is rubbish," Dann reports in the Lancet that more than 5,000 injections have been given in the past six years at the Swansea medical center without the preshot cleansing. No infections have developed.

But the swab should not be discarded entirely. Injections into the spinal cord or joints, and for patients on high doses of cortisone-like drugs, should be performed under strictly sterile conditions. Then, Dann contends, sterilization can be ensured only if the swabbing lasts for at least two minutes.

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