FDA report shows meat producers continue overusing antibiotics

Almost 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. 

As its latest “Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals” shows, the Food and Drug Administration (FDA) is still not doing enough to reduce the overuse of antibiotics in meat production. Sales of medically important antibiotics to meat producers decreased by just 0.2% from 2020 to 2021. That falls well short of the significant reduction in antibiotic use needed to address antibiotic resistance. Antibiotic overuse in any setting makes these precious drugs less effective as dangerous drug-resistant bacteria flourish. The FDA must take swift and substantial action to reduce antibiotic overuse across animal agriculture.

The FDA’s Perspective

The FDA issued a brief update accompanying the sales report that projects a facade of progress onto a more concerning reality. With regard to medically important antibiotics, the FDA offered, “Compared to 2015 (peak year of sales), 2021 sales decreased 38%.” That’s true, but using peak sales to measure progress is misleading because it masks future increases. For example, sales of medically important antibiotics in animal agriculture have increased by 8% since 2017, suggesting that the FDA has not done enough to reduce overuse in recent years.

The FDA started collecting this data in 2009, but given the scope of the gathering effort, the 2010 data was likely the first to paint a full picture of antibiotic sales. The agency should use the 2010 data as a baseline and set a target of a 50% reduction in sales of medically important antibiotics by 2025. Those sales have already decreased by 27% from 2010 to 2021, so the 50% target is achievable in the next two years as long as the FDA takes decisive action.

The FDA’s 2013 Guidance for Industry (GFI) #213, effective beginning in 2017, expanded veterinary oversight and banned antibiotic use for growth promotion. The ADUFA report shows that sales of medically important antibiotics to animal agriculture increased from 2013 through 2015 and then dropped significantly over the next two years, which is presumably attributable to compliance with GFI #213. 

Both the agency’s ban on antibiotics for growth promotion, which has its own problems, and the increase in veterinary oversight were low-hanging fruit and long-overdue steps toward ending the glaring overuse of these miracle drugs. The FDA shouldn’t rest on its laurels. 

Chicken Production: Progress Eroding  

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, Pizza Hut and KFC, have eliminated medically important antibiotics from their chicken supply chains serving the United States. The FDA’s data show the effect of these significant chicken purchasers on the industry: Medically important antibiotic sales to chicken producers declined by 41% from 2017 to 2020, making it the only major meat sector with any decline over that time frame. Given that context, it is surprising and concerning to see that trend now moving in the opposite direction, with a 12% increase in those sales from 2020 to 2021. We need robust antibiotic use data to determine why hard-won progress on reducing antibiotic overuse in chicken production is eroding.  

Antibiotic Class Breakdown

The 0.2% overall decrease in sales of medically important antibiotics to meat producers from 2020-2021 doesn’t tell the whole story. It’s skewed by a 19% decrease in sales of penicillins. Rather than signaling a renewed commitment to antibiotic stewardship, this is likely partially attributable to shortages of veterinary penicillin products since early 2021. 

Penicillins (-19%) and tetracyclines (-1%) were the only medically important antibiotic classes for which sales to animal agriculture decreased from 2020 to 2021; the other seven such classes all saw an increase in sales. 

Macrolides had the largest sales increase of any such drug class – 21% – from 2020-2021. Many beef producers use macrolides to prevent liver abscesses in cattle despite them being considered “highest priority critically important” by the World Health Organization (WHO). This overuse 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 many other infections.

The overuse of our most highly prized drugs isn’t theoretical: It’s playing out in our backyard. The London-based Bureau of Investigative Journalism recently released this article alleging 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. Here’s what it should do moving forward:

1. Set a public goal of reducing antibiotic use in animal agriculture by 50% by 2025, relative to a 2010 baseline. Since medically important antibiotic sales to meat producers decreased by 27% from 2010 to 2021, we’re already more than halfway there. The European Union achieved a comparable reduction in just ten years, so it’s doable if the FDA makes it a priority.
2. Collect robust antibiotic use data for meat production so the FDA can assess its progress toward this target and remain accountable to the public. 

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.