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I think deleting infected user accounts may help with removing ad-ware, spyware, and unwanted programs which may not be installed on other user accounts during installation.

So long as its local and you make sure to scan other connected accounts, it just gets really messy with domain accounts.

I imagine scanning a lot of user files can take a long time if the computer is slow.

It can be, but also depends on the age of the scanner as well.

Maybe using a lightweight Linux OS with a virus scanner like ClamAV can make scanning faster because there are probably command line antivirus which can remove viruses on a Windows drive partition.

Never heard of ClamAV, is it any good?

I think ClamAV is good because it is free, and can detect many Windows, Linux, and Apple malware. But, its virus detection rate may not be as good as more popular antivirus.