U.S. restaurants face scrutiny over antibiotic policies

by · News-Medical

As antibiotic-resistant superbugs threaten global health, a new report reveals how top U.S. restaurant chains are shaping—and failing to shape—the future of food safety.

In a recent report published by the Food Animal Concerns Trust (FACT), researchers evaluated the effectiveness of popular United States (US) food chains' anti-superbug policies. They scored companies across policy strength, implementation, and transparency and revealed that Chipotle and KFC were the most proactive in their anti-superbug efforts, while Olive Garden, Sonic, and Dairy Queen were the least.

The current report highlights the central role of food companies in curbing the genesis and spread of deadly superbugs. Compared to the previous FACT report (2015-2021), the present report notes that the chicken sector was observed to substantially attenuate its preemptive antibiotic use. However, significant gaps remain in beef, pork, and turkey policies, where antibiotic overuse continues largely unchecked. In contrast, the holistic meat sector (poultry, pork, and beef) depicted alarming trends of unnecessary antibiotic use and limited policy transparency.

Background

Drivers of antimicrobial resistance: Over 70% of medically important antibiotics in the U.S. are used in agriculture, primarily for growth promotion and infection prevention in livestock, emphasizing a critical area for intervention.

Modern medicine's contributions to alleviating disease, improving patients' quality of life, and extending human lifespans cannot be understated. Of the extensive research and progress in the field, the discovery and leveraging of penicillin and subsequent antibiotics have arguably played the most profound role in treating infections and achieving modern medicine's benefits.

Unfortunately, the unnecessary and widespread overuse of antibiotics has resulted in the genesis of 'superbugs' – antibiotic-resistant populations of bacteria and fungi with unprecedented tolerance to conventional treatment options, resulting in hard- or even impossible-to-treat infections. A growing body of evidence implicates the preemptive use of antibiotics in healthy individuals (humans or livestock) as a profound driver of superbug genesis, thereby highlighting the need for policy implementation aimed at responsible antibiotic use across both medical and animal husbandry sectors.

Addressing this need, the Food Animal Concerns Trust (FACT), in collaboration with scholars from the Keep Antibiotics Working (KAW) agency and George Washington University, periodically releases reports grading the adoption of anti-antibiotic-overuse policies implemented in popular United States (US)-based food chain companies. These reports provide consumers with information on company ratings (A+ to F), urging them to support companies with higher ratings to curb the unprecedented spread of superbug infections and the latter's associated mortality and morbidity.

About the FACT Report 2024

The most recent FACT report (2024) builds upon previous publications by the research team in evaluating the policies of popular US food chain companies to curb the spread of antibiotic resistance in livestock and, subsequently, served meat products. The report grades companies on a multifaceted scale, further evaluating their effectiveness in monitoring the implementation of their policies and the transparency with which these efforts are publicized. Data was gathered through company websites, email correspondence with company representatives, and independent evaluations (where available).

Impact of Environmental Factors: Environmental pollution, including antibiotic residues in wastewater and agricultural runoff, contributes significantly to the spread of AMR genes, creating reservoirs for resistance.

The report's ‘policy and implementation' aspects awarded 20 food chains and restaurants points based on their willingness to proactively prevent preemptive antibiotic use in the production of their served meats. Unfortunately, unlike in the case of vaccinations, the unnecessary overuse of antibiotics in healthy animals does little to improve livestock immunity. Instead, it provides the ideal nursery for the genesis and development of superbugs. Moreover, this is particularly evident in beef and pork production, where companies have made limited progress compared to the strides observed in the chicken sector. The consumption of these superbug-infected meats subsequently transfers the pathogens to humans, thereby resulting in the spread of multidrug-resistant pathogens, which are hard- or even impossible to treat using conventional pharmacological approaches.

The report further evaluated food companies' monitoring and tracking efforts to ensure that their livestock/meat suppliers comply with prevalent antibiotic use recommendations, including these companies' use of independent third-party verification systems to provide unbiased assessments of responsible antibiotic use. Finally, the transparency with which companies publicize their internal antibiotic use policies to scientists and consumers was graded. While Chipotle demonstrated leading transparency efforts, several companies, including Panera, lacked sufficient public-facing details or failed to disclose key changes in their policies.

Scores from these three aspects (1. Policy and Implementation, 2. Monitoring, 3. Transparency) were adjusted based on company-specific meat sale (a single meat type as in the case of KFC [only chicken] versus multiple served types of meat [e.g., McDonald's]) to provide a final company grade. The grades ranged from A+ (best) to F (worst).

Report Findings

Chipotle and KFC were found to be by far the most proactive in implementing policies aimed at curbing antibiotic use in healthy livestock, receiving A+ and A ratings, respectively. Chipotle’s policies comprehensively cover beef, pork, and chicken, making it the gold standard in this report. Notably, while companies such as McDonald's, Wendy's, and Subway received high scores for their chicken-centric policy implementation, their overall scores dropped drastically, given their irrelevance to ensuring antibiotic-free production of other meats (beef, pork, turkey, etc.).

Role of Wildlife and the Environment: Migratory and sedentary wild birds are reservoirs of antibiotic-resistant bacteria, highlighting the interconnectedness of human, animal, and environmental health in AMR's spread.

Less than half of the 20 evaluated companies (n = 7) were observed to employ the United States Department of Agriculture (USDA) 's Processed Verified Program (PVP) or similar licensed 3rd-party meat production verification. This reflects the sector-wide reluctance to adopt rigorous external monitoring practices, especially in beef and pork production. While Panera does claim internal auditing of their meat sources, the details of this auditing process and associated monitoring information were unavailable to researchers.

Transparency evaluations were similarly underwhelming, with only nine of the 20 restaurants responding to the authors' requests for antibiotic policy and monitoring information. Thirteen companies were observed to openly report their internal antibiotic use stats, with Chipotle standing out for the extent of details shared.

The report also highlights the resurgence of harmful practices such as the use of carbadox, a carcinogenic feed additive banned in several countries but still used in US pork production. Chipotle is the only company explicitly prohibiting its use, while Panera and others have backtracked on previous commitments to eliminate it.

Conclusions

Overall, Chipotle (A+), KFC (A), Wendy's (B), and Chick-fil-A (B) received the highest grades, while Little Caesars, Arby's, Olive Garden, SONIC, and Dairy Queen received the worst ones (F). Panera, previously demonstrating excellent antibiotic policies and commitments (A grade during the 2015-2021 FACT report), depicted the starkest grade change, dropping to D alongside its reversal of its antibiotic-free meat supply chain policies.

These findings highlight the shortcomings of many popular US restaurants, pointing out aspects requiring attention. The report also underscores that while the chicken sector demonstrates significant progress, other meat categories remain a substantial challenge. They further inform consumers of the ideal companies to financially support to ensure their health and combat the larger global superbug issue.

Sources: