DATE
Chris Kempczinski
McDonald’s Corporation, CEO

Dear Mr. Kempczinski,
 
We write to you as health 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.
 
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 followed through on that commitment.
 
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. Antibiotic resistance is often considered a silent and slow burning pandemic.
 
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. go each year. 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 potentially infect people with dangerous illnesses.
 
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 that sector accounts for 41 percent of the medically important antibiotics sold to the meat industry in the U.S. The 2018 commitment would restrict use and set reduction targets for medically important antibiotics across 85 percent of its global beef supply chain by the end of 2020. This  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.
 
However, as far as we can determine, McDonald’s missed its 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:

1. Following through on setting meaningful reduction targets for medically important antibiotics across 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.
2. Publicly reporting on progress regarding your commitment to prohibit routine use of medically important antibiotics for prevention of disease.
3. Adopting third-party, independent auditor 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.
 
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 also set an important example for other fast food companies who have made similar commitments to do so, and help spark change.
 
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

Debbie Pelkey, RN

Gillie Ramírez
Registered Nurse
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

Dominique Motta, RN, BSN, CCM

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

Toni Winter MSN RN

Emily Shaw, MD
Family Physician
Sutter Medical Group of the Redwoods

Brandon Cortez, MD

Terry Winter, RN, MPH

Anna Frattolillo, MA LMFT

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.

Robert Martinez, MD

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, Ph.D, 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

Rosemary Diamant, CRNP

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
Epdemiologist
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