Consumers Union has released its third annual “Chain Reaction” report on the prevalence of antibiotics in meat products in America’s most popular chain restaurants. Sadly, the results show most of the restaurants have failed to improve, even in the face of drug-resistant superbugs.

The rankings are based on each companies’ own policies for the use of antibiotic in meat and poultry products that they buy.

Pumping chickens, cows and pigs full of antibiotics intended for humans is slowly destroying our ability to treat common infections. The U.N. has called it a growing concern and potential global health crisis. More than 23,000 people die annually in the U.S. from antibiotic-resistant infections each year, according the the CDC.

To combat this problem, doctors and hospitals use antibiotics more judiciously than in the past, yet 70 percent of all antibiotics sold in the U.S. aren’t intended for human use anyway, but rather in animal agriculture.

“The nation’s fast food restaurant chains are in a unique position to address the antibiotic resistance crisis,” the report says, since they are the biggest buyers of meat and poultry. McDonald’s reportedly is the largest beef buyer, while fast-food restaurants purchase about 25 percent of all U.S. chicken. Chipotle and Panera scored well in the report, but 19 popular restaurants scored a C or worse.

Here’s the scoreboard:

A: Chipotle, Panera

B+: Subway

B: Chick-fil-A

B-: Taco Bell, KFC

C+: McDonald’s

C: Wendy’s

D+: Pizza Hut, Starbucks

D: Dunkin’ Donuts, Jack in the Box, Burger King, Papa Johns

F: Applebee’s, Dairy Queen, Sonic, Olive Garden, Little Caesars, Arby’s, IHOP, Cracker Barrel, Buffalo Wild Wings, Chili’s, Domino’s Pizza

It’s important to note that while progress has been made, this largely has occurred in chicken production. With few exceptions, companies have made little effort to eliminate antibiotics in pork and beef supplies. Chipotle and Panera are the only two restaurants to to currently serve antibiotic free beef and pork products, earning them top ranking. Subway serves antibiotic free poultry, and has committed to extending that to its pork and beef over a long timeline. While it doesn’t fulfill this promise yet, it earned a B+ for being aware and implementing change.

KFC is the most improved brand from 2016 to 2017 — jumping from an F to a B-. The company committed to transitioning fully to antibiotic-free meat by the end of 2018.

Unfortunately, 11 of the top 25 fast food chains have taken almost no action to reduce the use of human antibiotics in their supply chains.

(h/t Grub Street)

Eat less meat with tasty vegetarian options. 

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Meghan is a full-time writer exploring the fun facts behind food. She lives a healthy lifestyle but lives for breakfast, dessert and anything with marinara. She’s thrown away just as many meals as she’s proud of.