Antibiotic Resistance in Food: The 2026 EFSA Report Explained

Antimicrobial resistance, or AMR, occurs when bacteria evolve to survive exposure to the drugs designed to kill them. It is a natural process, but antibiotic overuse has dramatically accelerated it. When bacteria are repeatedly exposed to antibiotics, the susceptible strains die and the resistant ones survive and multiply. Resistance spreads.

The global scale is significant. A 2022 Lancet study02724-0/fulltext) found that bacterial AMR was directly responsible for 1.27 million deaths in 2019 and contributed to nearly 5 million deaths worldwide. A 2024 Lancet forecast projected more than 39 million deaths directly attributable to AMR between 2025 and 2050 if current trends continue.

Those figures are dominated by hospital-acquired infections. But food is a meaningful transmission route for the bacteria that develop and carry resistance, and the story of how they move from farm to fork is one that most food labels do not tell you.

The mechanism is straightforward, even if the solution is not.

Animals in intensive farming operations, particularly poultry, cattle, and pigs, have historically been given antibiotics not just to treat illness but to promote growth and prevent disease in crowded conditions. The WHO identifies the misuse and overuse of antimicrobials in animals, humans, and plants as the primary driver of drug-resistant pathogens globally.

In the US, approximately 70% of antibiotics used to treat human infections are also approved for use in veterinary medicine. The EU has moved faster on restrictions, banning antibiotic use for growth promotion in food animals. But use for disease prevention in herds and flocks remains legal and common.

When animals carry resistant bacteria in their guts, those bacteria can contaminate meat during slaughter and processing. They can also enter soil and water through animal waste, which then contaminates produce. A head of lettuce can carry resistant bacteria picked up from irrigation water that passed through farmland. This is a documented pathway, not a theoretical one.

Once in a kitchen, cross-contamination is the primary risk. A cutting board used for raw chicken, then used for salad preparation, becomes a transfer point. Cooking destroys bacteria, whether resistant or not. Raw foods that contact contaminated surfaces do not have that protection.

The joint report covers data from 2023 and 2024 across 27 EU member states, the UK, and five additional countries. Three bacteria were the focus: Salmonella, Campylobacter, and carbapenemase-producing E. coli.

Campylobacter and the Ciprofloxacin Problem

Campylobacter is the most commonly reported cause of bacterial foodborne illness in the EU. It is primarily transmitted through undercooked poultry. The 2026 report found widespread resistance to ciprofloxacin, a fluoroquinolone antibiotic that has historically been the first-line treatment for severe Campylobacter infections.

The finding is serious enough that EFSA now states ciprofloxacin is "no longer recommended for the treatment of human infections" with Campylobacter. That sentence marks a clinical shift driven by agricultural practice. A drug that doctors relied on has effectively been removed from the recommended toolkit for one of the most common foodborne pathogens, because resistance has become too widespread to make it reliable.

Resistance to ampicillin, tetracyclines, and sulfonamides was also described as persistently high in both Campylobacter and Salmonella.

Salmonella: Some Progress, Persistent Gaps

The Salmonella picture is more mixed. Ampicillin resistance declined in 19 countries over the past decade. Tetracycline resistance declined in 14 countries. Resistance in broilers and turkeys to these drugs showed downward trends, which EFSA attributes in part to tightened antibiotic stewardship policies.

But resistance to ciprofloxacin in Salmonella remains high across both human and animal sources. Improvement in some drugs has not extended across the board.

The Carbapenem Warning

The most significant concern in the 2026 report involves carbapenemase-producing E. coli. Carbapenems are described as "last-resort antimicrobials for humans." They are the drugs used when everything else has failed.

EFSA found carbapenemase-producing E. coli being detected in food-producing animals and meat across several countries, with detection numbers increasing. The report emphasizes that combined resistance to critically important antimicrobials remains "generally low." But the direction matters. The presence of carbapenem-resistant bacteria in the food supply is a signal that requires attention.

Poultry carries the highest concentration of the bacteria covered in the EFSA report. Campylobacter is almost universally associated with chicken, and Salmonella contamination in poultry is well-documented across regulatory surveillance.

Red meat, particularly pork, is a secondary source. Raw produce irrigated with water near livestock operations is a third. Shellfish can carry resistant bacteria through contaminated water.

Processed and packaged meats introduce additional risk. The industrial scale of slaughter and processing means contamination from a single animal or batch can spread across many products. This is why Listeria, Salmonella, and E. coli recalls often affect widely distributed packaged goods rather than single items.

Pasteurised dairy products carry lower risk. Raw milk and raw milk cheeses present higher exposure.

The CDC is clear that most people infected with resistant foodborne bacteria do not need antibiotics to recover. The body clears many foodborne infections on its own. The risk from AMR specifically arises when an infection is severe enough to require antibiotic treatment, and the available drugs do not work.

Children, the elderly, pregnant individuals, and people with compromised immune systems face greater risk. They are more likely to develop infections serious enough to require antibiotics, which means drug failure has more direct consequences for these groups.

For most adults, the practical message is consistent: thorough cooking destroys resistant bacteria just as it destroys susceptible ones. The risk is in handling and cross-contamination, not in eating well-cooked food.

Steps that reduce risk in the kitchen:

• Cook poultry to an internal temperature of at least 74°C (165°F) / 165°F throughout
• Use separate cutting boards for raw meat and ready-to-eat produce, or wash and sanitise thoroughly between uses
• Wash hands for at least 20 seconds after handling raw meat
• Refrigerate leftovers promptly and avoid leaving cooked food at room temperature for extended periods

This is where packaging intersects directly with the AMR issue.

Labels that indicate antibiotic-free production practices carry real meaning. Look for:

• "Raised without antibiotics" or "No antibiotics ever" — indicates the animal received no antibiotics at any point in its life. These claims are verified by the USDA in the US.
• "Organic" (EU-certified) — EU organic standards ban routine prophylactic antibiotic use in livestock entirely.
• "USDA Organic" — prohibits antibiotic use in US livestock; animals that receive antibiotic treatment must be removed from the organic program.

Research suggests these labels correspond to lower rates of resistant bacteria in the final product compared to conventionally raised equivalents, though the difference varies by pathogen and product category.

What labels cannot tell you: whether the product was processed on shared equipment that may have carried resistant bacteria from another batch. That information is not visible to consumers.

The EU banned antibiotic growth promoters in livestock in 2006 and has progressively restricted prophylactic use since. The annual EFSA-ECDC surveillance report is part of a structured monitoring program designed to track resistance trends across the food chain and inform policy.

The one health framework, which the report explicitly endorses, treats human, animal, and environmental health as interconnected. That framing has moved from academic language into regulatory policy across the EU, WHO, and many national governments.

Progress is real. The declining resistance to ampicillin and tetracyclines in several countries shows that targeted policy intervention can work. It is also slower than the spread of resistance in some areas, particularly ciprofloxacin resistance in Campylobacter, which appears to have outpaced the response.

The carbapenem detection data is a warning about where the trend leads if the response stalls.

Antibiotic resistance is not something you can detect by looking at food. Resistant bacteria are visually and physically identical to susceptible ones. The difference only becomes clear if you get sick and standard treatment does not work.

That invisibility is part of why label literacy matters. Seeking out organic certification or verified antibiotic-free claims on poultry and meat is one of the few actionable choices available at the point of purchase. It does not eliminate risk, but it does reflect a meaningful difference in how the animal was raised and what bacterial populations it was exposed to.

IngrediCheck lets you scan packaged food products and understand exactly what the label is telling you, including claims about antibiotic and farming practices. For meat and processed food products, having that information clearly decoded is one practical tool for navigating choices that the EFSA report shows genuinely matter.