To reduce antibiotic resistance, we should aim to reduce antibiotic use in agriculture to only treating animals that are sick, which is the way we use antibiotics in humans. I think this is the way we should use antibiotics in animals, and I have absolutely no problem with that.

But we still have this very substantial category of antibiotic use that the industry calls “preventive,” meaning not curing infections but for the prevention and control of disease. That’s what tripped up antibiotic reform in Europe and I fear it’s what going to trip up antibiotic reform in the U.S.

That said, most of the companies that have relinquished antibiotic use in poultry have relinquished most preventive antibiotics as well. So, for the most part, chicken [producers have] solved this problem. The antibiotics that are still being used for preventive use in chickens, by some companies, are this category called ionophores, which don’t have any analog in human medicine.

Given that producers have been amenable to changing the way they raise chickens, what’s the role of consumers?

We wouldn’t be where we are now without the consumer movement. Healthcare institutions, school systems, chefs, and farms all created this groundswell that made it possible for the FDA to issue this guidance and made it safe for companies to agree. Most of these companies didn’t do what they did because they strongly believe antibiotic resistance is a worldwide peril. They changed their practices because they were afraid they were going to sell less chicken.

But the consumer movement could also keep going. They could say that we really only want to see antibiotics used in animals that are sick. And they need to say it not only about poultry, which has already moved in this direction, but also about cattle and pigs, which are going to be more complicated.