One step forward, two steps back on overuse of antibiotics in meat production

About two-thirds of the medically important antibiotics sold in the United States go to meat production. The routine feeding of these drugs to animals that aren’t even sick is undermining the effectiveness of life-saving medicines for the sake of a slightly cheaper hamburger or pork chop.

Are we making progress on antibiotic overuse?

Yes and no. The Food and Drug Administration’s (FDA) most recent annual report on sales of medically important antibiotics to meat producers is a mixed bag at best.[1] The chicken industry continues to phase out the drugs, with a 4% decline in medically important antibiotics purchased from 2021 to 2022 and a 43% drop since 2017. But beef and pork producers bought more medically important antibiotics in 2022 than in any year since 2016. Total sales of medically important antibiotics to meat producers (specifically beef, chicken, pork and turkey) rose by 5% from 2021 to 2022 – just the latest warning that we’re still moving in the wrong direction on antibiotic overuse. What’s more, those four meat industries collectively purchased more of all nine listed medically important antibiotic classes in 2022 than in 2021. The continued overuse of these precious drugs is making them less effective as dangerous drug-resistant bacteria flourish, and the FDA should take swift and substantial action to protect public health. 

The FDA’s perspective misses the whole picture

The FDA issued a brief update accompanying its report that projects a facade of progress onto a more concerning reality: sales of medically important antibiotics for use across animal agriculture (not just beef, chicken, pork and turkey, but also fish and others) rose 4% from 2021 to 2022. The agency noted that those sales have declined since 2015, the peak year of sales.[2] That’s true, but it doesn’t tell the whole story.

Sales of medically important antibiotics for use in animal agriculture did drop significantly from the 2015 peak to 2017 – presumably as meat producers came into compliance with the FDA expanding veterinary oversight and banning antibiotic use for growth promotion beginning in January 2017. 

However, sales of medically important antibiotics for use in animal agriculture have increased by 12% since 2017, suggesting that the FDA has not done enough to reduce overuse in recent years. The agency’s use of peak sales to measure progress is misleading because it masks this more recent increase.

Instead, the FDA should measure progress from 2009, the first year of data collection, and set a target of a 50% reduction in sales of medically important antibiotics for use in animal agriculture by 2030. Given the 19% reduction in those sales from 2009 to 2022, we’re already more than a third of the way there.

Hard-won progress on chicken overshadowed by continued overuse in beef and pork

The best way to limit the spread of antibiotic-resistant superbugs is to reduce the use of the drugs in the first place. Thus, declining antibiotic use in chicken production has been a victory for public health over the last decade. Several fast food chains, including McDonald’s, Taco Bell and KFC, have eliminated medically important antibiotics from their chicken supply chains serving the United States, causing an industry-wide shift: medically important antibiotic sales to chicken producers have declined by 43% since 2017. 

But we’re not even treading water on beef and pork: medically important antibiotic sales to those industries crept up from 2021 to 2022, hitting their highest totals since 2016. The FDA should focus its efforts on reducing antibiotic overuse in those sectors.

All nine primary medically important antibiotic classes had increased sales

If the 5% year-over-year increase in medically important antibiotic sales to meat producers was limited to a particular drug or class of drugs, it might be possible to attribute it to a widespread disease outbreak or change in operations. Instead, sales of all nine listed medically important antibiotic classes to meat producers increased from 2021 to 2022, suggesting more of a “business as usual” approach to antibiotic use that gives superbugs more opportunities to flourish and spread. 

After macrolide sales to meat producers increased 17% from 2020 to 2021, those sales increased by 9% from 2021 to 2022. Routine dosing with macrolide antibiotics has long been the beef industry’s solution to prevent liver abscesses in cattle, despite evidence that adjusting grain-heavy diets can reduce their incidence without antibiotics. The overuse of these drugs – considered “highest priority critically important” by the World Health Organization (WHO) – risks compromising their effectiveness in human health care, where physicians rely on them as one of only a few treatments for Campylobacter infections and frequently use them to treat other infections.

The overuse of our most highly prized drugs isn’t theoretical: It’s playing out in our backyard. In November 2022, the London-based Bureau of Investigative Journalism and The Guardian alleged the use of highest priority critically important antibiotic classes in the beef supply chains of McDonald’s, Taco Bell and Walmart. Even if the FDA doesn’t act, you can make a difference by patronizing restaurants that serve beef raised without antibiotic overuse. 

What now?

The FDA has a public health responsibility to reduce antibiotic use in animal agriculture. The agency should publicly set a goal of reducing medically important antibiotic sales to animal agriculture by 50% by 2030, relative to a 2009 baseline. Since medically important antibiotic sales to animal agriculture decreased by 19% from 2009 to 2022, we’re more than one-third of the way there. The European Union cut antibiotic use in half in just ten years, so it’s doable if the FDA makes it a priority.

Without swift action to reduce antibiotic use, we risk living in a post-antibiotic world that some say has already arrived. It’s time for the FDA to step up.

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[1] “Antimicrobials” is typically an umbrella term including antibiotics, antifungals and other drugs that target microorganisms. The use of the term “antibiotics” throughout the post can be assumed to be equivalent to the FDA’s use of “antimicrobials.”

[2] FDA sales data has only been broken out by animal species since 2016, so it’s not possible to do this analysis for the four major meat production sectors specifically.