We thank Dr Lecat for his interest in our article on contamination of stethoscopes after a physical examination. We agree that our study was not designed to identify the optimal decontamination strategy. Numerous articles have examined potential decontamination strategies, including ethanol wipes,
1isopropyl alcohol swabs,
9benzalkonium chloride swabs,
11and ethanol-based hand rub solution.
12All these disinfectants were found to substantially reduce the microbial burden on stethoscopes. However, because few comparative studies have been conducted, the optimal method of decontamination remains to be identified. In addition, other aspects such as ease of use, accessibility, and compatibility should also be considered when selecting a decontamination method.
Regrettably, despite the publication of several studies on the infectious risks associated with stethoscopes, physicians still fail to comply with this simple rule. Studies have shown that 47% to 86% of health care workers do not disinfect their stethoscope regularly
14and that only 6% to 15% disinfect their stethoscope after every use.
15As a solution, Dr Lecat suggests advancement of proper behavior through education and promotion strategies. However, there are reasons to believe that such strategies would be of limited efficacy. For example, despite numerous campaigns stressing the importance of hand hygiene, physicians’ compliance with this simple gesture remains distressingly low.
17There are few reasons to believe that physicians could be any better at disinfecting their stethoscope than they are at disinfecting their own hands.
Confronted with this situation, a more appealing, feasible, and scientifically sound solution should be to ban the use of personal stethoscopes and replace them with dedicated stethoscopes available at every patient’s bedside. This strategy would have the immediate benefit of greatly reducing the risk of transmitting potential pathogens between patients through this instrument.
Regardless, we appreciate Dr Lecat’s comments and suggestions. Clearly, future research is warranted to identify methods to decrease the infectious risks associated with the use of stethoscopes.
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