U.S. hospitals are evaluated on their ability to reduce the incidence of infections patients acquire during their stays, but there’s surprisingly little evidence suggesting the best method to disinfect surfaces in patient rooms.

An abundance of research looks at the number of bacteria on a surface before and after cleaning and disinfecting. But few studies have taken the next step to specifically evaluate to what degree those procedures led to fewer patients getting sick. Even fewer studies compared the effectiveness of one environmental cleaning method over another, according to an analysis published Aug. 10 in the Annals of Internal Medicine.

“There is a paucity of studies that can guide the actions of physicians and hospitals,” said Dr. Craig Umscheid, director of the center for evidence based medicine at the University of Pennsylvania’s Perelman School of Medicine. The ideal study would be to randomize the selection of different approaches, compare the findings and then look at patient-centered outcomes, such as colonization and infection rates. “It’s doable,” he said. “But we found very few.”

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