In Australia as in many other countries cleaning followed by high-level disinfection is recommended as the minimum standard for nasopharyngoscopes whether or not a sterile sheath is used during the procedure.

The Australian/New Zealand Standard™ (AS/NZS 4187) "Cleaning, disinfecting and sterilizing reusable medical and surgical instruments and equipment, and maintenance of associated environments in health care facilities)", states that "sheaths/sleeves for instruments and equipment shall not be used as a substitute for cleaning, disinfection or sterilisation procedures".

The recommendation has impacted on services in terms of increased inventory requirements, equipment turnaround time and costs along with decreased productivity.

Until recently the bacteriological efficacy for cleaning and intermediate-level disinfection has been lacking.

In 2009/2010 Alvarado and Elackattu using rigorous microbiological methods to assess contamination of nasopharyngoscopes have demonstrated the reliability of meticulous cleaning, intermediate-level disinfection with 70% ethanol and the use of sterile sheaths in protecting nasopharyngoscopes from contamination with bacterial pathogens and viruses.

In light of the current evidence Australian/New Zealand Standards should revise the stringent requirement for high-level disinfection to reduced reprocessing turnaround times and costs which in turn will allow opportunities to improve productivity.