This “letter to the editor” is a response to the study by Sickbert-Bennett et al (American Journal of Infection Control 2005;33:67-77) which evaluated hand hygiene agents common in US hospitals. In this study a 10-second application time was selected because it was considered more realistic and relevant to clinical conditions than the 20- to 60-second applications used in most other studies. The authors of the letter state “although the topic deserves investigation, they believe that the study’s findings must be interpreted carefully because of major limitations in its design”. These limitations are discussed in the letter. American Journal of Infection Control 2005;33:558-60.