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Gale S Pollock, Response to Response—Letter to Editor. Nasal Decolonization in Congregate Settings: Reducing Infection Spread, Cutting Costs and Improving Operational Readiness, Military Medicine, Volume 190, Issue 5-6, May/June 2025, Page 160, https://doi.org/10.1093/milmed/usae476
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I appreciate Dr. David Dooley’s letter to the editor in response to my November 2023 Commentary, “Nasal Decolonization in Congregate Settings: Reducing Infection Spread, Cutting Costs, and Improving Operational Readiness” (Republished in May/June 2024). The Commentary section is intended to provide a place for new original data, speculative synthesis, and provides an opportunity for authors to inject their experiences and opinions.
Dr. Dooley correctly asserts that there is no effectiveness data for the use of this maneuver (ethanol application, also referenced as an alcohol-based nasal antiseptic) in congregate settings outside of hospitals—however, he incorrectly asserts no data on the intervention’s effectiveness and tolerability exists. When last I checked, there were more than 20 independent studies that attest to the effectiveness of the alcohol-based approach in hospital settings—which are also congregate settings. The latest published study, a meta-analysis demonstrating that alcohol-based nasal decolonization approaches were superior to iodophor or mupirocin, is currently in press in the American Journal of Infection Control. Additionally, the alcohol-based approach is currently being used in military hospitals, negating Dr. Dooley’s assertion that the intervention may not be tolerable to our service members.