Abstract
BACKGROUND: The CDC and WHO recommend alcohol-based hand sanitizers to inactivate severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2]. AIM: Benzalkonium chloride [BAK] is another hand sanitizer active ingredient that could be used in response to the global pandemic. Deployment of BAK-based hand sanitizers could reduce shortages of alcohol products and increase hand hygiene options where there are social, physical, and toxicological constraints on alcohol use. METHODS: Two commercially available BAK-based hand sanitizers, a concentrate diluted on-site with water and a ready-to-use product, were tested for activity against SARS-CoV-2 in the European Norm Virucidal Activity Suspension Test [EN14476]. A WHO and CDC-recommended 80% alcohol-based hand sanitizer formulation was tested in parallel. FINDINGS: Both BAK formulations demonstrated a ≥4.0 log(10) reduction of SARS-CoV-2 in 30 seconds, meeting the EN14476 performance standard for virucidal activity against SARS-CoV-2 and matching the in vitro effectiveness of the ethanol-based sanitizer. CONCLUSION: These findings indicate that a commercial BAK hand hygiene formulation may be another effective means of inactivating the SARS-CoV-2 virus and could be considered as option for pandemic response.