Every year some 2 million Americans get infections from antibiotic-resistant bacteria, and 23,000 of them die from these superbugs.
Superbugs are mostly a hospital problem: They're where these pathogens are often born and spread, and where the infected come for help. But hospitals are not where the majority of antibiotics sold in the U.S. are used.
Food and Drug Administration data show that 62 percent of antibiotics important for human health are sold to food animal producers and used on farms. And in December, the agency noted that antibiotics for use on the farm increased in 2014, including antibiotics important in human medicine.
Concern about the livestock industry's overuse of antibiotics has led a number of health care institutions to start choosing meat from animals raised without antibiotics whenever they can. According to Practice Greenhealth, a nonprofit that's helping the health care industry on this issue, more than 400 U.S. hospitals are working toward a goal of making 20 percent of their meat purchases "antibiotic-free." And around a dozen hospitals have already switched the majority of their chicken purchases to antibiotic-free.
"Health care is really voicing their demand for [antibiotic-free meat] products," says Hillary Bisnett, a food expert for Practice Greenhealth and Health Care Without Harm. "Hospitals understand antibiotic resistance, and they're being asked to steward their own use of antibiotics. So it's very easy for them to say, 'Livestock producers need to be doing their part, too.' "
Is meat from animals raised without antibiotics really better? Public health groups who follow this issue, like the Pew Charitable Trusts, say it can be safer. Of greatest concern is that when chicken, hog or cattle farmers use drugs to promote growth or prevent disease in their animals, they'll overuse the drugs and create resistant bacteria, like Salmonella and Campylobacter, that could make people sick.
Various studies, including ones by George Washington University microbiologist Lance Price and advocacy groups like Consumer Reports and the Environmental Working Group, have found resistant bacteria on samples of beef, pork, turkey and chicken from supermarkets. If meat contaminated this way isn't cooked properly, the resistant bacteria can infect humans. And if the pathogens are resistant to antibiotics designed to kill them, then doctors may have few tools to treat the infections.
Among the hospitals that have made antibiotic-free meat a priority for their food services is Hackensack University Medical Center in New Jersey. But according to Kyle Tafuri, senior sustainability adviser at the hospital, it wasn't easy to figure out how to switch 100 percent of their chicken purchases to antibiotic-free.
At first, the hospital's distributor said it didn't have enough antibiotic-free chicken to sell the hospital. But over the course of a few years, and after several meetings with the distributor and a group purchasing organization, they were able to find a way to make it work.
Eventually, Tafuri says, the supplier, Perdue, agreed to specially ship the chicken up to the distributor's warehouse just for the hospital. "It took a lot of work to make this happen and a lot of pushing, but hospitals should be inclined to push the industry to make a change," he says.
His hospital pays 30 percent more for Perdue's antibiotic-free chicken under its Harvestland brand, but Tafuri says it's worth it to his institution to be able to offer a "higher quality and healthier product." He's now working on sourcing more antibiotic-free pork and beef, but he says they're dramatically more expensive, and more difficult to source.
"The biggest challenge is budget," says Linamen. He's also struggled to find antibiotic-free sources for specific items, like chicken strips, sausage patties, duck and lamb.
Part of what explains Linamen and Tafuri's success in getting more antibiotic-free meat on the plates they serve is the fact that neither of their institutions is locked into a contract with a big food service management company, like Aramark, Sodexo or Compass, says Bisnett of Practice Greenhealth. Many other hospitals tell her they would like to source more antibiotic-free meat but can't, because their contracts do not allow them to.
The biggest food-service management companies have very limited supply of these items. And the hospitals "don't have flexibility in changing vendors or supply," says Bisnett.
"That's why it's really important that the food service sector get more involved with this issue, too, since one third of hospitals in the U.S. have food service managed by Sodexo, Compass or Aramark," she says.
Hospitals are far from the only big buyers to get interested in sourcing antibiotic-free meat and apply pressure to biggest meat producers, like Perdue, Tyson, JBS and Smithfield, to make more of it available. Several restaurant and retail chains in 2015 committed to sourcing more antibiotic-free meat, including McDonalds, Subway, Panera, CostCo and Chick-fil-A. Some have committed to sourcing antibiotic-free poultry, while others have also given suppliers of beef and pork a mandatory timetable to go antibiotic-free as well.