Health professionals urge McDonald’s to reduce antibiotic use

 

May 26, 2022

Chris Kempczinski

McDonald’s Corporation, CEO

Dear Mr. Kempczinski,

We write to you as health care professionals to express our ongoing concerns about the overuse of antibiotics in livestock production. We see the devastating consequences of antibiotic resistance first-hand in the medical field, and we’re urging you to take action now to reduce antibiotic use and help keep these life-saving medicines effective. McDonald’s position as a global leader in the fast food industry is vital in this effort.

When McDonald’s stopped serving chicken raised with medically important antibiotics in 2016, we welcomed the change. After your 2018 commitment to set targets for reducing medically important antibiotics in beef production by the end of 2020, we considered McDonald’s a true leader in efforts to preserve these drugs. That’s why we’re disappointed that it seems McDonald’s has not not followed through on that commitment.

Antibiotic resistance is often considered a silent and slow burning pandemic, but the World Health Organization and the Centers for Disease Control and Prevention (CDC) consider antibiotic-resistant bacteria among the top threats to global public health. Millions of Americans get sick each year from drug-resistant infections. One estimate suggests drug-resistant infections account for up to 160,000 annual deaths [1].

Overusing antibiotics in any setting can spur resistance, but it’s critical we work to reduce use in the livestock sector, where nearly two-thirds of medically important antibiotics sold in the U.S. are used each year [2]. Meat producers overuse these antibiotics, routinely giving them to animals that are not sick to prevent diseases caused by unsanitary, overcrowded, and stressful conditions. That practice spurs the growth of antibiotic-resistant bacteria, which can then spread from farms and ultimately infect people and cause dangerous illnesses [3].

While we believe that antibiotics should be used to treat sick animals-just as we treat sick people-they should not be used to compensate for industrial farming conditions.

McDonald’s commitment to reduce antibiotic use in beef is crucial because this sector accounts for 41 percent of the medically important antibiotics sold to the meat industry in the U.S. [4]. Your 2018 commitment would restrict use and set reduction targets for medically important antibiotics across 85 percent of McDonald’s global beef supply chain by the end of 2020. Your policy also included a commitment to phase out routine use of medically important antibiotics for prevention of disease. These commitments rightly were based on the 2017 World Health Organization “Guidelines on Use of Medically Important Antimicrobials in Food-Producing Animals” as clearly indicated in the 2018 announcement [5].

As far as we can tell, McDonald’s missed its own 2020 deadline for setting reduction targets, and has not publicly reported any progress toward phasing out the routine use of the drugs.

We are calling on McDonald’s to fulfill its previous commitments and continue to lead on this issue by:

• Following through on setting meaningful reduction targets for medically important antibiotics across 85 percent of your global beef supply chain. Aggressive reductions will be especially important for the U.S. market, where sales of medically important antibiotics for use on cattle continue to rise.
• Publicly reporting on progress regarding your commitment to prohibit routine use of medically important antibiotics for prevention of disease.
• Adopting third-party, independent auditors with expertise in antibiotics to verify antibiotics use practices amongst your suppliers, to ensure public confidence in your progress.

Increasingly, consumers are asking for meat raised without the routine use of antibiotics. According to a recent national poll, labels claiming that meat was raised without antibiotics were important to two-thirds of consumers surveyed[6].

As a leader in the fast food sector and the beef production industry, McDonald’s is poised to lead the way in producing meat ethically and without the overuse of antibiotics. Fulfilling your commitment to reduce antibiotic use in beef will set the tone for other fast food companies, and help spark transformative change for health across the globe.

We appreciate your attention to this pressing issue.

Respectfully,

Sameer J. Patel, MD, MPH

Medical Director, Antimicrobial Stewardship Program

Attending Physician, Division of Infectious Diseases

Payal K. Patel, MD, MPH

Division of Infectious Diseases

Assistant Professor, University of Michigan Health System

Scott Weissman, MD

Pediatric Infectious Disease specialist

Talene A. Metjian, Pharm.D.

Clinical Pharmacy Specialist in Infectious Diseases

Sujit Suchindran, MD, MPH

Assistant Professor of Medicine

Division of Infectious Diseases, Emory University School of Medicine

John Pauk

Medical Director of Antimicrobial Stewardship and Infectious Diseases

Swedish Medical Center

Brian Werth

Associate Professor of Pharmacy

University of Washington School of Pharmacy

Liza Vaezi

Infectious Diseases Pharmacist

Virginia Mason Medical Center

Andrew Goldstein, MD

Progressive Doctors

David Rosen, MD, PhD

Washington University School of Medicine

Jonathan D. Moreno

David and Lyn Silfen University Professor

University of Pennsylvania

Jon S. Jacobson, MD

Ophthalmologist

Gillie Ram?rez, RN

NYC Department of Education

Kristina Beglarian, FNP

Oxford health network

Allison Mullarney

Internal Medicine Hospitalist

Mithya Lewis-Newby, MD MPH

Pediatric Cardiac Critical Care Physician and Bioethicist

Seattle Children’s Hospital and University of Washington

Richard E. Kanner, MD

Professor of Medicine

University of Utah School of Medicine

John H. Holmes, PhD, FACE, FACMI

Professor of Medical Informatics in Epidemiology

University of Pennsylvania Perelman School of Medicine

Kimberly Brouwer

Professor & Infectious Disease Epidemiologist

University of California San Diego, H.W. School of Public Health

William Parks, MD

Retired Emergency Physician

Kevin Foskett

Chair, Department of Physiology

University of Pennsylvania School of Medicine

Joanna Benavidex

Psychologist

Private Practice

Steffanie Strathdee, PhD

Associate Dean, Global Health Sciences, Co-Director of IPATH

University of California San Diego

Dona Kim Murphey, MD PhD

Neurologist Neuroscientist

In Phase Neuro, LLC

Janet Perlman, MD, MPH

UCSF

Richard M. Baldo, Ph.D.

Clinical Psychologist

Richard M. Baldo, Ph.D., Inc.

Andrea Schindler, DO

Retired Family Physician

Ilene Tannenbaum

NP/Director

Brooklyn College Health Clinic

Erin Schauer, MOT, OTR/L

Emory University Hospital

Martin Gelman, MD

Radiologist

Jennifer Cecilia Fish, MD

Family Medicine Physician

Sutter Santa Rosa Family Medicine Residency Program

Jessica Stanton, MD

West County Health Centers

Wendy Kohatsu, MD / Chef

Associate Clinical Professor, Family & Community Medicine

University of California, San Francisco

Panna Lossy, MD

Sutter Santa Rosa Family Medicine Residency

Kambria Beck Holder, MD

Family Physician

Leilani Zimmerman

Community Health Family Nurse Practitioner

Santa Rosa Community Health

Jared Garrison-Jakel, MD MPH

West County Health Centers

Emily Shaw, MD

Family Physician

Sutter Medical Group of the Redwoods

David Schneider, MD

Clinical Professor of Family & Community Medicine, UC San Francisco School of Medicine/Clinical Professor of Pharmacy, UC San Francisco School of Pharmacy

Audra Lehman, MD

Family Physician

Kaiser Permanente

Terry Isaacson, PhD

Stadium Park Student Housing

Tony H Tran, MD

Gastroenterologist

Mercy OKC

Ashley Jones

Pharmacist

Emory healthcare

Kinna Thakarar, DO MPH

Assistant professor of medicine

Maine medical center/Tufts university school of medicine

Irana Hawkins, PhD, MPH, RDN

Public Health Doctoral Faculty

Walden University

Jeremy Rossman, PhD

Virologist

University of Kent

Ahmed Abdul Azim, MD

Assistant Professor of Medicine

Division of Infectious Diseases, Rutgers Robert Wood Johnson Medical School

Laila Woc-Colburn

Associate Professor

Emory University School Of Medicine

Danny Toub

Clinician Lead for Antimicrobial Stewardship

Santa Rosa Community Health

Alan Peterson, MD

Emeritus Director of Environmental and Community Medicine

Lancaster General Hospital

Rosie Amini, PharmD. BCPS

Senior Clinical Pharmacy Advisor

Premier, Inc.

Taylor Heald-Sargent

Assistant Professor

Northwestern University

Tara Vijayan

Medical Director, Adult Antimicrobial Stewardship

University of California, Los Angeles

Julianna Van Enk, PharmD

Antimicrobial Stewardship Pharmacist

MultiCare Tacoma General Hospital

Elisa Glubok Gonzalez

Family Physician

Santa Rosa Family Medicine Residency

Michael Diamond

Executive Director

The Infection Prevention Strategy

Richard E. Kanner, MD

Professor of Medicine

University of Utah School of Medicine

Paul H. Axelsen MD

Professor of Pharmacology and Infectious Diseases

University of Pennsylvania

Bill Sullivan, PhD

Professor

Indiana University School of Medicine

Lipi Roy, MD, MPH

Medical Director

Housing Works

Andrew M. Morris

Professor, Infectious Diseases

Sinai Health, University Health Network and University of Toronto

Kevin Outterson

Professor

Boston University School of Law

Anna Valdez, PhD, RN

Professor and Chair of Nursing

Sonoma State University

Murtaza Akhter, MD

University of Arizona College of Medicine-Phoenix

Lori Burrows PhD, FAAM, FCAHS

Interim Director

MDG Institute for Infectious Disease Research, McMaster University

Suzanne Stensaas

Professor of Neurobiology, Emerita

Steven J Zelman, MD

Nephrologist

Southern Illinois Consultants for Kidney Disease

Rachael Stalker, MSN, FNP-BC, RN

Nurse Practitioner

Robin Taylor Wilson

Associate Professor of Epidemiology & Biostatistics

Temple University

Betelihem Tobo

Assistant Professor

Temple University College of Public Health

Jesse Karagianes

SVP Revenue and Groeth

CV Sciences, Inc.

Susan Spanos

Microbiology Supervisor

The Everett Clinic, Everett, WA.

Daniel Pak, PharmD

Antimicrobial Stewardship Pharmacist

Seattle Children’s Hospital

Catherine Liu, MD

Professor & Director of Antimicrobial Stewardship

Fred Hutchinson Cancer Research Center

Beverly Leite MD

Infectious Disease Specialist

Rosie Amini

Senior Clinical Pharmacy Advisor

Premier, Inc.

Molly Hayes, PharmD

Clinical Pharmacist, Infectious Diseases

The Children’s Hospital of Philadelphia

Jacqueleen Wise

Infectious Disease Nurse Practitioner

Rachael Pines, CRNP

The Children’s Hospital of Philadelphia

Louis M. Bell, MD

Associate Chair of Clinical Programs,

The Children’s Hospital of Philadelphia

Maria Mascarenhas

Medical Director, Integrative Health Program

Children’s Hospital of Philadelphia

Lindsey Albenberg, DO

Pediatric Gastroenterologist

Children’s Hospital of Philadelphia

Katie Chiotos, MD

Pediatric Infectious Diseases Specialist

Winona Chua, MD

Clinical Associate Professor of Pediatrics

Perelman School of Medicine, University of Pennsylvania

Susan E. Martin

CRNP-PC/AC

Children’s Hospital of Philadelphia

Carsten Krueger, MD, FRCP(C)

Clinical Infectious Diseases Fellow

Children’s Hospital of Eastern Ontario

Michael E. Russo

Pediatric Infectious Diseases Physician

Kristin H. Wheatley, PharmD

Clinical Pharmacy Specialist, Pediatric Infectious Diseases

Katherine Dobbs, MD

Pediatric Infectious Diseases specialist

Sandra Arnold, MD, MSc

Professor of Pediatrics and Chief, Division of Infectious Diseases

University of Tennessee Health Science Center

Shivang Shah, MD, DPhil

Assistant Professor of Pediatrics, Division of Infectious Diseases

Columbia University

Mayssa Abuali, MD

Pediatric Infectious Diseases Specialist

Einstein Medical Center Philadelphia

Patricia Pichilingue-Reto, MD, FAAP, AAHIVS

Assistant Professor of Pediatrics, Infectious Diseases

Louisiana State University Health System – Shreveport

Kelley Lee, Pharm.D., BCPS AQ-ID

Clinical Pharmacist – Antimicrobial Stewardship

Le Bonheur Children’s Hospital, Memphis, TN

Jason G Newland

Pediatric Infectious Diseases

Washington University in St. Louis

Trahern W. Jones, MD, MMC, FAAP

Assistant Professor of Pediatric Infectious Diseases

University of Utah School of Medicine

Annabelle de St. Maurice

Assistant Professor Pediatric Infectious Diseases

UCLA

Ankita Desai, MD

Pediatric Infectious Diseases, Medical Director of Antimicrobial Stewardship

UH Rainbow Babies and Children’s Hospital

Michael L. Chang, MD

Director of Pediatric Antimicrobial Stewardship

UTHealth Houston McGovern Medical School

Emily Keller, MD

Attending, Pediatric Infectious Diseases

Advocate Children’s Hospital

Karen Davidge, PharmD

Clinical Pharmacist Specialist – Pediatric Infectious Diseases

Michigan Medicine

Amisha Malhotra, MD

Associate Professor, Pediatric Infectious Disease

Rutgers- Robert Wood Johnson Medical School

Peter Cooch

Infectious Diseases Pediatrician, Director of Pediatric Antimicrobial Stewardship

Kaiser Oakland

Gary Preston, MA, PhD, CIC, FSHEA

Epidemiologist

Healthcare Management Alternatives, Inc.

Hayden Schwenk, MD, MPH

Clinical Associate Professor

Stanford University School of Medicine

Kevin Meesters, MD, MPH, PhD

Pediatric Infectious Diseases Fellow

David Zhang

Assistant Professor of Pediatric Infectious Disease

University Hospitals

Federico Laham, MD

Pediatric Infectious Diseases

Arnold Palmer Hospital for Children at Orlando Health

Julie Martin, MD

Children’s Hospital of Georgia

Joshua Wolf

Medical Director of Antimicrobial Stewardship

St. Jude Children’s Research Hospital

Kailynn DeRonde

Pediatric Infectious Disease Pharmacist

Jackson Medical Center

Jessica Tansmore, PharmD, BCIDP

Advanced Patient Care Pharmacist- Antimicrobial Stewardship

Nationwide Children’s Hospital

Paul K. Sue, MD, CM

Pediatric Infectious Diseases

UT Southwestern Medical Center

Stefania Vergnano, Dr

Bristol Royal Hospital for Children,UK

Preeti Jaggi

Medical Director of Antimicrobial Stewardship

Children’s Healthcare of Atlanta

Rosemary Olivero

Director of Antimicrobial Stewardship

Helen DeVos Children’s Hospital of Spectrum Health

Reshma Ramachandran, MD, MPP

Physician Fellow

Yale National Clinician Scholars Program

Pavel Prusakov, PharmD

Antimicrobial Stewardship Pharmacist

Nationwide Children’s Hospital

Benjamin S. Avner, MD, PhD

Western Michigan University Homer Stryker MD School of Medicine

Bryan Meyers, MD MPH

Washington University School of Medicine

Marc H. Scheetz, PharmD, MSc

Midwestern University

Jim Rhodes, PharmD

Midwestern University, Northwestern Memorial Hospital

Debbie Pelkey, RN

Rosemary Diamant, CRNP

Robert Martinez, MD

Brandon Cortez, MD

Terry Winter, RN, MPH

Anna Frattolillo, MA, LMFT

Toni Winter MSN, RN

Dominique Motta, RN, BSN, CCM

1Journal of Infection Control and Hospital Epidemiology, New Estimate of Annual Deaths Caused by Treatment Resistant Infections Highlights Gaps in Research, Stewardship, Surveillance3 December 2018,https://www.idsociety.org/es/news-publications-new/articles/2018/new-estimate-of-annual-deaths-caused-by-treatment-resistant-infections-highlights-gaps-in-research-stewardship-surveillance/

2U.S. Food and Drug Administration (hereinafter FDA), Center for Veterinary Medicine, 2016 Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals, December 2017,https://www.fda.gov/AnimalVeterinary/NewsEvents/CVMUpdates/ucm588086.htm. Data on 2015 sales of antibiotics for human medicine in the United States were obtained from Eili Klein of the Center for Disease Dynamics, Economics & Policy (CCDEP). Klein also provided data for years prior to 2015 in Kar, A., and Klein, E. “Animal Antibiotic Sales Finally Drop, but Much Work Remains,” Natural Resources Defense Council (hereinafter NRDC), December 2017,https://www.nrdc.org/experts/avinash-kar/animal-antibiotic-sales-finally-drop-much-work-remains. CDDEP also provided those figures for years preceding 2015; 2016 data are not yet available.

[5] Natural Resources Defense Council, Livestock Antibiotic Sales See Big Drop, but Remain High, 18 December 2018,https://www.nrdc.org/experts/avinash-kar/livestock-antibiotic-sales-drop-remain-very-high.

[6] “Medically-important antibiotics” or “antibiotics important to human medicine” refers to antibiotics that are the same as, or similar to, classes of drugs used in human medicine. For example, the antibiotic tylosin, used in livestock, is a member of the medically-important macrolide class of antibiotics. Throughout this report, we will use the term “antibiotics” and “medically-important” antibiotics interchangeably, unless otherwise noted.

3US PIRG, Chain Reaction VI: How top restaurants rate on reducing antibiotic use in their beef supply chains, July 2021,https://uspirg.org/feature/usp/chain-reaction-vi

4FDA, Center for Veterinary Medicine, 2019 Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals, December 2020, https://www.fda.gov/media/144427/download.

5World Health Organization, WHO guidelines on use of medically important antimicrobials in food-producing animals, November 2017,https://www.who.int/publications/i/item/9789241550130

6 Forbes, Antibiotics-Free Labels are Important to Two Thirds Americans when Buying Meat – and Data to Back-Up Claims is Paramount, a New Poll Shows, February 2021,https://www.forbes.com/sites/johnzogby/2021/02/11/antibiotic-free-labels-are-important-to-two-thirds-of-americans-when-buying-meat–and-data-to-back-up-claims-is-paramount-a-new-poll-shows/?sh=2e22007b3c2b