In a recent report evaluating popular restaurant chains’ policies on antibiotics in meat, many chains received a failing grade. The use of antibiotics in meat-producing animals is of concern as it can contribute to the spread of drug-resistant foodborne pathogens and worsen the global public health threat of antimicrobial resistance (AMR).

The “Serving Up Superbugs” report grades the leading U.S. restaurant chains on their adoption of policies to restrict the overuse of antibiotics in the production of the meat they serve. Factors considered in a company’s grade included: 1) antibiotic use policies related to beef, turkey, pork, and chicken procurement, 2) policy implementation, 3) monitoring of antibiotic use in meat supplies, and 4) transparency, including verification of policy compliance via third-party audits and reporting on implementation progress. “Meaningful” antibiotic use policies were defined as “a publicly available company policy that prohibits the use of all antibiotics, or medically important antibiotics, for growth promotion and routine disease prevention.” The report considered preventive use of antibiotics in groups of animals to be “routine,” while antibiotic use for the treatment of individual sick animals and to control a diagnosed disease outbreak was considered acceptable.

The report points out that, in the last two decades, the U.S. chicken industry has significantly reduced the amount of antibiotics it uses, which has led to reductions in AMR in pathogens from chicken. Some efforts have been made in recent years to reduce the use of antibiotics in other meat supply chains, but those reductions have not been as meaningful as seen for chicken production.

For reference, according to the U.S. Food and Drug Administration’s (FDA’s) 2023 report on antimicrobials sold for use in food-producing animals, of the antibiotics sold in 2023, 44 percent and 41 percent were intended for use in swine and cattle, respectively. Only 10 percent were intended for use in turkeys, 2 percent for use in chickens, and 3 percent for other or unknown animal species.

Of the 20 restaurant chains graded, only Chipotle received an A+, while KFC was the single establishment to receive an A. Both companies had “meaningful” antibiotic policies for all meat types served in their restaurants. Wendy’s and Chick-fil-A received B grades, five chains received C grades (Popeyes, Taco Bell, Subway, McDonald’s and Starbucks), and another five chains received D grades (Pizza Hut, Domino’s, Dunkin’, Burger King, and Panera).

Chick-fil-A and Popeyes both had meaningful chicken policies, but their scores were negatively impacted by their lack of antibiotic policies for their pork supply chains.

Taco Bell increased its grade from previous reports into the C range by no longer selling chicken raised with antibiotics that are important to human medicine, and by committing to reduce medically important antibiotics in its beef supply by 25 percent by 2025—although the company did not specify how it intends to achieve this goal.

On the other hand, Panera’s grade was reduced from an A to a D after the company removed its longstanding policies for sourcing raised-without-antibiotics chicken, turkey, and pork, and limiting the use of medically important antibiotics in their beef.

F grades were given to five of the 20 top restaurant chains (Arby’s, Sonic Drive-In, Dairy Queen, Olive Garden, and Little Caesars) because they do not have public policies that require producers to act beyond legal compliance with FDA regulations to address AMR.

According to the report, despite having antibiotics policies, the majority of companies are still failing to track and report the use of antibiotics in the beef, pork, and turkey that they purchase. Only seven of 20 restaurants (KFC, Taco Bell, Pizza Hut, Wendy’s, Chick-fil-A, Chipotle, and Panera) use third-party verification to ensure responsible antibiotic use in their supply chain.

The report also highlighted the use of the carcinogenic feed additive carbadox in the U.S. meat supply, which is commonly used for growth promotion and disease control for pigs in industrial livestock operations. The drug breaks down into chemicals that can cause cancer in humans and can remain in meat as residues, exposing consumers. According to the report, FDA is “actively trying to ban carbadox,” but until it is removed from the market, it will continue to be used in the pork supply. Chipotle is the only company included in the report that explicitly does not allow carbadox in its meat supply. Panera’s previous antibiotics policy, which they rescinded, used to prohibit carbadox in its pork supply.

The “Serving Up Superbugs” report was written by Food Animals Concerns Trust (FACT), a nonprofit that promotes food safety and humane practices in the production of meat/poultry and dairy, and its Keep Antibiotics Working Coalition (KAW), which is focused on addressing antibiotic use in the food industry to mitigate AMR. KAW includes member organizations like the Center for Food Safety, Consumer Reports, the Environmental Working Group, Stop Foodborne Illness, the U.S. Public Interest Research Group, and other advocacy groups.