By now, you've probably seen news reports highlighting incurable — and usually fatal — "superbug" infections that are resistant to antibiotics. But did you know that the antibiotics in food, including your favorite fast-food burger or pepperoni pizza, may be upping your risk of developing one of these infections?
The overuse and misuse of antimicrobials in the U.S. food supply, particularly in beef production, is recognized by both the World Health Organization and the Centers for Disease Control and Prevention (CDC), as a contributing factor in the life-threatening, drug-resistant infections in humans that are on the rise. According to the CDC, at least 2 million people in the U.S. contract an antibiotic-resistant infection every year, and at least 23,000 people will die as a result.
"Antibiotic resistance is one of the greatest public health threats we face — locally and globally," explains Sameer Patel, MD, an infectious disease specialist at the Lurie Children's Hospital in Chicago. "We commonly see patients become ill or die from antibiotic-resistant infections, and it's an increasingly common occurrence across all parts of our healthcare system — from community clinics to cancer wards." Even common infections, like urinary tract infections and pneumonia, can become life-threatening if the antibiotics used to treat them are ineffective due to drug resistance.
Antibiotic Use in Animals
Approximately 70 percent of all medically important antibiotics in the United States are sold for use in animals. It's common practice in large-scale animal agriculture in the U.S. to provide antibiotics in feed or water to promote growth or fend off diseases and infections caused by overcrowded, stressful living that can compromise farm animals' immune systems.
According to the CDC, giving antibiotics to animals kills harmful bacteria but also allows resistant bacteria to survive and multiply. These drug-resistant bacteria can live in the animal meat and then be ingested by humans, where it can alter a healthy gut microbiome. They can also spread in the environment through animal feces, agricultural dust, irrigation systems, streams and other natural supplies of water.
"Many large-scale farms are like factories for producing superbugs that can spread throughout the environment and to humans in a number of ways," explains Matthew Wellington, director of the Campaign to Stop the Overuse of Antibiotics at the United States Public Interest Research Group (PIRG), a consumer advocacy group.
Making changes to our food production system is one of the best ways to help reduce the risk for creating and spreading drug-resistant bacteria to humans. For example, in November 2017, the World Health Organization (WHO) released guidelines for farmers and the food industry to stop the routine use of antibiotics for increasing growth and to help prevent illnesses among animals raised for food. The European Union already bans the practice of using antimicrobials for growth promotion and the Food and Drug Administration banned the practice in the United States in 2017. WHO guidelines recommend only using antibiotics when animals are sick.
But while some food producers have updated their policies to reflect these better practices, others still have a ways to go.
Antibiotics in Your Favorite Fast Food
In October 2019, PIRG released its fifth annual Chain Reaction report, which graded the nation's largest chain restaurants based on their policies around antibiotics in the beef they use.
PIRG's report scored the top 25 chain and fast-casual restaurants, from McDonald's and Panera Bread to Pizza Hut and Panda Express, on how closely they're following WHO's antibiotic guidelines and other responsible practices. Since these restaurant chains represent the largest purchasers of beef in the country, revealing which chains are taking the right steps (versus those that aren't) is a way to help increase public awareness of the issue and to create increased demand for animal-based foods that follow WHO's recommendations.
The results indicate that few of the top chains are getting good — or even passing — grades. The highest scores were awarded to Chipotle and Panera Bread, who both garnered As and have been leading the restaurant industry with their sustainable meat and poultry policies that cover antibiotics. While not officially included in the report, due to their smaller size, Shake Shake and BurgerFI are also considered best in class for their policies. These leaders show that it's possible to serve millions of meals a day using more sustainable and healthier beef and poultry products while growing their business, according to the report.
Those making progress included McDonald's and Subway, who earned C grades. Both have policies around antibiotic use but have not yet implemented them. McDonald's, the largest purchaser of beef in the world, says it will do so by the end of 2020. Subway also has not yet implemented its policy.
Ds and Fs went to most of the other top restaurant chains, including Wendy's (D) and Taco Bell (D), who have taken only baby steps in addressing the issue. A long list of top chains scored failing grades (Fs) due to their complete lack of policies around this issue: Applebee's, Burger King, Dairy Queen, IHOP, Jack in the Box and Pizza Hut.
Arby's, Buffalo Wild Wings, Chili's, Domino's Pizza, Little Caesar's, Olive Garden, Panda Express, Sonic and Starbucks received Fs because they did not return their surveys to PIRG.
What You Can Do
Antibiotics are a shared and vital public resource, and it's important to track and reduce antibiotic use in both food and medicine, so that these life-saving drugs may be effective for us and for future generations, says Dr. Patel.
Here are four ways you can make that happen:
1. Use your purchasing power: Buy meat and poultry products from animals raised without antibiotics. When shopping at your local supermarket, look for brands of meat and poultry that state raised without antibiotics or other such language. There are no official standards for antibiotic labeling, but foods that bear the USDA Organic label are not raised with antibiotics. Some reputable brands in the beef industry known to have responsible policies include Niman Ranch, Meyer Natural Foods, Organic Valley and Applegate Farms.
2. Support restaurants that are doing the right thing: One of the most effective things you can do is patronize restaurants with good policies, like Chipotle and Panera Bread, says Wellington. And steer clear of those who fall into the failing category.
3. Voice your concern: Reach out to your favorite chain restaurants who are getting poor grades and let them know you're not OK with their beef-sourcing practices. We know this is an effective tactic because the chicken industry has essentially eliminated the use of antibiotics in their farms due to pressure from companies like KFC and McDonald's who wanted to provide consumers with chicken products free from antibiotics. Soon thereafter, Perdue Farms announced it would reduce or eliminate the practice of using antibiotics. That forced the other major chicken producers to do the same to remain competitive.
4. Make it political: Finally, ask your legislators to pass commonsense legislation that can reduce unnecessary antibiotic overuse on farms.
"We're still waiting on who is going to be the Perdue Farms of the beef industry," says Wellington. "But we hope our Chain Reaction report will increase awareness in the issue and produce some meaningful changes."
- Centers for Disease Control and Prevention: "Antibiotic/Antimicrobial Resistance (AR/AMR): Food and Food Animals"
- World Health Organization: "Antimicrobial resistance in the food chain"
- Centers for Disease Control and Prevention: "Antibiotic/Antimicrobial Resistance (AR/AMR)"
- U.S. PIRG Education Fund: "Chain Reaction V"
- World Health Organization: "WHO guidelines on use of medically important antimicrobials in food-producing animals"