The increase in antibiotic-resistant bacteria has led to one of the most pressing public health issues of our time, and major fast food restaurants across the U.S. are responding by vowing to nix antibiotic use in their meat and poultry supplies.

But knowing which chains are making the greatest effort is challenging for consumers. Last year, a survey by Consumers Union, the policy and mobilization arm of Consumer Reports, and five other consumer, environmental, and health organizations, found that only five of the 25 top restaurant chains had made some commitment to serving meat raised without antibiotics. Antibiotic use in healthy animals contributes to antibiotic resistance, reducing the effectiveness of those lifesaving drugs to cure illnesses in people.

Now, the results of this year’s report (PDF) are in, and there has been some improvement: nine of the 25 fast-food restaurants have made such commitments. Restaurants have made particularly good progress in sourcing the chicken they serve from farmers who do not use antibiotics. By 2017, all chicken sold at Chipotle, McDonald’s, Panera Bread, and Subway will have been raised without antibiotics, says Jean Halloran, director of food policy initiatives at Consumers Union.

“If you’re a consumer who buys fast food and wants to help fight antibiotic resistance, you could start by ordering chicken at those four restaurants,” Halloran says. “But still, we’d like to see more restaurants serving 'no antibiotic' chicken and also 'no antibiotic' beef and pork.” 

On Wednesday, Sept. 21, Consumer Reports president and CEO Marta L. Tellado will be sitting on a panel convened to address the global problem of antibiotic resistance at the United Nations General Assembly meeting in New York. Tellado is one of only six people from around the world who are not government delegates who have been invited to participate. 

The Trouble With Antibiotics

The Centers for Disease Control and Prevention estimates that about 2 million people in the U.S. are infected with drug-resistant bacteria each year. Of those, some 23,000 die.

Much of the problem stems from the rampant overuse of antibiotics in healthy farm animals to fatten them up quickly and prevent illness in crowded and unsanitary factory farming conditions. That practice breeds bacteria that can no longer be destroyed by these lifesaving drugs. Those resistant bacteria can end up in the food supply and can infect you—leading to serious, potentially deadly illness. Infection can come from touching or eating undercooked contaminated meat or plants grown with fertilizer made from animals treated with antibiotics, or by drinking tainted groundwater. Studies even suggest that resistant bacteria could be transmitted through the air.

“We have exploding rates of antibiotic resistance and plummeting rates of new antibiotics being developed," says Brad Spellberg, M.D., chief medical officer at the Los Angeles County + University of Southern California Medical Center. "It is a huge problem.” 

Making the Grade

This year’s report, "Chain Reaction II: How Top Restaurants Rate on Reducing Use of Antibiotics in Their Meat Supply," was prepared by Consumers Union, the Center for Food Safety, Friends of the Earth, Food Animal Concerns Trust, and the Natural Resources Defense Council. In the report, the top 25 fast-food and fast-casual restaurant chains are graded on their antibiotic policies. According to the report, the main goal is to encourage companies to adopt good policies that prohibit routine antibiotic use for growth promotion or disease prevention across all the meats they serve. It's also important that they set a schedule for implementing their no-antibiotic policy. Those criteria account for 40 percent of a company’s grade.

The companies were sent a survey, and their responses—along with public statements by the companies either in the press or on their websites—were used to calculate the score. Twice as many fast-food restaurants responded this year as did last year.

“It’s encouraging to see progress, but the majority of the top 25 still have not done anything, and we really think that they need to step up to the plate and take action,” Halloran says.

How the top 25 fast food restaurants in the U.S. scored in the Chain Reaction II report.

Chipotle and Panera keep their A grade from last year; almost all of the meat they serve—including beef, chicken, pork, and turkey—was raised without the use of any antibiotics.

Subway notably upped last year’s score from an F to a B; currently 67 percent of its chicken is raised without antibiotics. It promises that all of the chicken it serves will be "no antibiotic" by the end of 2016 and that all of the meat will be by 2025. (Techniques for raising chickens without antibiotics are better developed than those for cattle and hogs, Halloran says.)

Chick-fil-A has similarly earned a B, pledging that all of its chicken (the vast majority of the meat it serves) will be raised completely without antibiotics by 2018. It's currently about a quarter of the way to that goal.

McDonald’s gets a C+ for having a clear policy and converting 100 percent of its chicken supply to those raised without medically important antibiotics. But it has made no commitment to switching its beef and pork supplies. Wendy’s got a C, and Taco Bell rated a C-, in part for making some, though limited, progress on chicken.

Dunkin’ Donuts was downgraded from last year’s C to an F, joining the likes of Burger King, IHOP, KFC, and Starbucks. That’s because it revised its original policy statement late in 2015 to indicate that it does allow for the use of antibiotics.

Some smaller chains were also highlighted in this year’s report for having good antibiotic use policies, but were not part of the survey because they aren’t one of the 25 top chains. These include Au Bon Pain, which has a “No Antibiotics. Ever.” policy for all chicken and turkey used to make salads, sandwiches, and wraps in its 310 restaurants in the U.S. and abroad; California-based Tender Greens, which uses "no antibiotic" meat and poultry; and pizza chain Papa Murphy’s, which sources chicken raised without antibiotics at all of its 1,500-plus locations globally.

“The future effectiveness of antibiotics depends on making sure they are used only when absolutely necessary, to treat a sick animal or control an identified disease outbreak,” Halloran says. “Fast food restaurants should help protect public health by moving away from serving meat and poultry from suppliers who misuse these vital drugs.” 

If you want to help encourage fast food restaurants to take antibiotics off the menu, sign Consumers Union’s petition, which will be sent to the CEOs of the chains that received a failing grade.