Getting Antibiotics off the Menu

Sophie E. Katz, MD, MPH

November 11, 2021

I was born and raised in Louisiana, where food and agriculture are two major tenets of our culture. (I will always argue that Cajun food is the best cuisine.)

My grandparents lived in the middle of farmland in a small Louisiana town, and I still treasure driving by fields of sugar cane and cows because it feels like home. Although you’d never guess it from his gentle demeanor (he’s a retired social worker), my father is also a true cowboy – he grew up participating in rodeos and raising cattle in that small Louisiana town.

I’ve moved away to much larger cities and a few different states since graduating from high school, but you could say that animals and agriculture will always be a part of my identity. I suspect that this is a feeling that resonates with many other people, no matter which state or country you grew up in.

One Health is a concept that recognizes that the health of humans is closely related to the health of animals and our shared environment. As someone with an interest in antimicrobial stewardship, I find that this concept connects my professional passion for combatting antibiotic resistance with my personal love for animals and agriculture.

Humans are exposed to antimicrobials used in animals and agriculture, and the subsequent antimicrobial-resistant organisms that they promote, not only through the food we eat, but also through the water we drink (for instance, if it was collected downstream from a livestock farm) and in our sewerage systems. The heavy use of antibiotics on farms can undermine our ability to cure bacterial infections.

Before 2017, antibiotics were used frequently in food-animal production to promote animal growth. The FDA implemented rules that year banning the use of medically important antibiotics for growth promotion and requiring veterinary oversight for using antibiotics in water and feed. Now, much of the preventive antibiotic use (especially in beef and pork) is to compensate for poor nutrition and unsanitary and stressful living conditions of livestock that contribute to disease. So, there likely was an increase in antibiotic sales for agriculture in 2020 because of the COVID-19 pandemic, which led to market disruptions and overcrowding.

The Centers for Disease Control and Prevention estimates that each year in the U.S., at least 2.8 million people get antibiotic-resistant infections and more than 35,000 people die as a result.

None of the four major beef processor companies (Cargill, JBS, Tyson or National Beef) report data publicly on the amount of antibiotics used to produce the meat they sell, and none have adopted policies restricting the routine use of antibiotics in feed lots, according to the Chain Reaction VI: How Top Restaurants Rate on Reducing Antibiotic Use in Their Beef Supply Chains scorecard that was published in July 2021. This interesting scorecard by Consumer Reports, Natural Resources Defense Council, the Antibiotic Resistance Action Center, the Center for Food Safety, Food Animal Concerns Trust, and U.S. PRIG Education Fund annually ranks the top 20 fast food and fast casual U.S. chains that serve beef based on the policies and actions related to antibiotic use in their beef supplies.

This year, Chipotle Mexican Grill and Panera Bread were the only two restaurants to receive an A or A- score. Twelve restaurants received a score of F. None of the companies surveyed use third party verification consistently across their beef supplies to monitor responsible antibiotic use.

Antibiotic Awareness Week is Nov. 18-24, 2021. During this week (and throughout the year), we should all commit to supporting restaurant chains that source meat with no or few antibiotics. We can also look for this commitment when purchasing meat in the grocery store. Additionally, we can raise our concerns and make our preferences known to our favorite restaurants on their websites or social media accounts.

“We should lobby federal regulators and policymakers to make changes at the national level that require companies to meet certain standards for antibiotic use in agriculture.”

We should push companies towards action and commitment. Finally, we should lobby federal regulators and policymakers to make changes at the national level that require companies to meet certain standards for antibiotic use in agriculture.

 

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.

About the Author

Sophie E. Katz, MD, MPH

Sophie E. Katz, MD, MPH, is a member of the AAP Committee on Infectious Diseases Antibiotic Stewardship Subcommittee and an Assistant Professor of Pediatric Infectious Diseases at Vanderbilt University Medical Center.