(CNN) Our favorite fast foods could come back to bite us, according to a report released Wednesday -- and it's not just the extra calories.

The new report grades the 25 largest US fast food chains on where they stand on antibiotics.

The results are a mixed bag: For the third year in a row, the only two As were awarded to Chipotle Mexican Grill and Panera Bread. More companies passed this year than ever before.

But 11 of the top 25 chains received an F, having taken "no (discernible) action to reduce use of antibiotics in their supply chains."

Nine companies didn't respond to the survey at all, just like last year.

While regulations and consumer pressure have encouraged some chains to cut back on the use of antibiotics, some experts worry it's not enough to stave off development of "superbugs" that can't be killed by some of our current medicines. These bugs may get into our meat and produce

"If we don't rein in this pattern of antibiotic resistance in bacteria, what we will see is half a century of medical progress reversed," said Lena Brook , a food policy advocate with the Natural Resources Defense Council. She has served as a lead expert on the report for each of the past three years.

Despite nearly half of restaurants receiving a failing grade, this is an improvement over the 16 that failed last year , the authors said.

"It's a rapid shift that we've seen in just a few short years, and that leaves me really hopeful," Brook said.

Who passed, and who didn't?

A total of 14 fast food and "fast casual" chains earned passing grades, a boost over nine last year. There were only five the year before that, in 2015.

"It is important to note, however, that while remarkable progress has been made to reduce or even eliminate use of medically important antibiotics, this progress has largely occurred in chicken production," the authors said.

This is how Chipotle and Panera have stood above the rest: by making sure that pork and beef -- in addition to poultry -- are raised without antibiotics.

"While we are pleased to see others in our industry follow our lead in this important area, this report shows that there is still more work to be done across the industry," Chris Arnold, a Chipotle spokesman, said in an email.

The credit for most improved goes to KFC , which jumped from an F last year to a B- after committing to phase "medically important" antibiotics out of its chicken supply by the end of 2018. Antibiotics are considered "medically important" for their use in humans, per the World Health Organization.

Subway earned a B+ for working to curtail antibiotics in poultry and meat. However, its plan to do the same with pork and beef was far off in the future in comparison, keeping it from an A.

antibiotics in their chicken. Earnings Bs and Cs were Wendy's Taco Bell and Chick-fil-A. All have made moves to reduceantibiotics in their chicken.

McDonald's also earned a C+, just like last year. The company updated its "Vision for Antibiotic Stewardship" policy in August, saying it planned to pare down unnecessary antibiotic use in all meats. However, the company failed to give a timeline for pork and beef, the new report said.

"We remain committed to making meaningful reductions in the use of antibiotics in beef and pork and will share our progress on beef in 2018," Marion Gross , senior vice president for McDonald's North America supply chain, said in a statement.

Pizza Hut "made a token effort," the report authors said, receiving a D+ for creating policies that affected only a small portion of its chicken. Starbucks earned the same grade for pledging to address antibiotic use in poultry, but not pork or beef.

Photos: Restaurant report card: How is your fast food meat raised? Chain Reaction III: The third annual "Chain Reaction" report grades America's 25 largest fast food and "fast casual" restaurants on their antibiotics policies and meat sourcing practices. These eleven restaurant chains received an F grade for the third consecutive year due to lack of a meaningful antibiotics policy. Nine of these companies didn't respond to the survey at all. Hide Caption 1 of 15 Photos: Restaurant report card: How is your fast food meat raised? Chipotle - Grade: A "We started on our quest to serve meat from animals raised without the use of antibiotics in 1999, and continue to be a leader in this area today," Chipotle spokesman Chris Arnold said in an email. "We made the decision to serve antibiotic-free meat simply because we thought it was the right thing to do -- the right thing for farmers, for animal welfare, and for human health -- and we continue to hold the belief today." Hide Caption 2 of 15 Photos: Restaurant report card: How is your fast food meat raised? Panera Bread - Grade: A "We're proud to have led the way on antibiotic reduction for more than a decade, starting with introducing chicken raised without antibiotics in 2004," Sara Burnett, director of wellness and food policy at Panera, said in a statement. "Today at Panera, 100% of poultry, bacon, breakfast sausage and ham served on sandwiches and salads is raised without antibiotics." Hide Caption 3 of 15 Photos: Restaurant report card: How is your fast food meat raised? Subway - Grade: B+ "Our U.S. restaurants only serve chicken raised without antibiotics and we continue to work towards the elimination of antibiotic use in our Turkey, Pork and Beef supply," Subway said in a statement. "Antibiotics are critical tools for keeping animals healthy and should be used responsibly to preserve their effectiveness in veterinary and human medicine. We are proud of our progress and are committed to continued work in this space." Hide Caption 4 of 15 Photos: Restaurant report card: How is your fast food meat raised? Chick-fil-A - Grade: B "Our efforts in the journey toward serving only chicken raised with No Antibiotics Ever (are) something our customers told us they wanted," Rob Dugas, vice president of Chick-fil-A's supply chain, said in a statement. "We have converted more than 50% of our supply to chicken raised with No Antibiotics Ever to date, and we are on track to achieve our goal of converting 100% of our chicken supply by December 31, 2019."



Hide Caption 5 of 15 Photos: Restaurant report card: How is your fast food meat raised? Taco Bell - Grade: B- Taco Bell did not immediately respond to CNN's request for comment. Hide Caption 6 of 15 Photos: Restaurant report card: How is your fast food meat raised? KFC - Grade: B- "We're proud to be the first major chicken chain to commit to removing antibiotics important to human medicine in all of our chicken, including bone-in chicken," the company said in a statement to CNN. "This change presented a unique challenge for us because we serve chicken-on-the-bone. As such, this move required close collaboration with our suppliers who bring KFC chicken from the farm to our kitchens where it is hand-prepared."

Hide Caption 7 of 15 Photos: Restaurant report card: How is your fast food meat raised? McDonald's - Grade: C+ "Moving to cage-free eggs by 2025, sourcing chicken raised without antibiotics important to human medicine since 2015, and introducing McNuggets with no artificial flavors, colors or preservatives are all examples of our continued commitment to our US customers," Marion Gross, senior vice president for McDonald's North America supply chain, said in a statement. "Because we know we can and must do more across the globe, last month we also announced that in 2018 we will begin implementing a chicken antibiotics policy in markets around the world. And we remain committed to making meaningful reductions in the use of antibiotics in beef and pork and will share our progress on beef in 2018." Hide Caption 8 of 15 Photos: Restaurant report card: How is your fast food meat raised? Wendy's - Grade: C "We continue to build on the progress we've made in phasing out the use of medically important antibiotics in our supply chain where possible," the company said in a statement. "Wendy's is committed to accomplishing this with the help of suppliers, farmers and ranchers. We believe the steps we are taking will make a difference in protecting the future health of people and animals." Hide Caption 9 of 15 Photos: Restaurant report card: How is your fast food meat raised? Pizza Hut - Grade: D+ Pizza Hut did not immediately respond to CNN's request for comment. Hide Caption 10 of 15 Photos: Restaurant report card: How is your fast food meat raised? Starbucks - Grade: D+ Starbucks did not immediately respond to CNN's request for comment. Hide Caption 11 of 15 Photos: Restaurant report card: How is your fast food meat raised? Dunkin' Donuts - Grade: D "We do not own, raise, process or transport livestock, but we recognize that animal welfare is an important part of a safe and sustainable food supply chain," the company said in a statement. "By the end of 2018, any chicken offered in Dunkin' Donuts restaurants will be sourced from chickens raised with no antibiotics ever." Hide Caption 12 of 15 Photos: Restaurant report card: How is your fast food meat raised? Burger King - Grade: D Burger King did not immediately respond to CNN's request for comment. Hide Caption 13 of 15 Photos: Restaurant report card: How is your fast food meat raised? Papa John's - Grade: D Papa John's did not immediately respond to CNN's request for comment. Hide Caption 14 of 15 Photos: Restaurant report card: How is your fast food meat raised? Jack in the Box - Grade: D Jack in the Box did not immediately respond to CNN's request for comment. Hide Caption 15 of 15

So what?

"Antibiotic resistance is one of the biggest health threats facing us today," says CNN Chief Medical Correspondent Dr. Sanjay Gupta. "We've taken too many drugs, and as a result, they don't work the way they used to."

When animals get antibiotics, often in their food or drinking water, the drugs may kill a number of bacteria. But a handful might harbor a gene that makes them resistant to drugs. Those bacteria may survive, multiply and spread.

These bugs "can move off of farms," Brook said, "and find their way into communities." They can even share their genes with weaker bacteria.

The US Centers for Disease Control and Prevention and the World Health Organization have repeatedly warned about the not-far-off public health threat of antibiotic resistance. The CDC estimates that at least 2 million Americans contract antibiotic-resistant infections every year and that 23,000 die as a result.

longer, more costly and more serious, And these infections are oftenlonger, more costly and more serious, according to the CDC.

The WHO cautioned in a 2014 report : "A post-antibiotic era -- in which common infections and minor injuries can kill -- far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century."

Taking steps

While some experts criticize the routine use of antibiotics, others defend the practice, saying that antibiotics play an important role in maintaining animal health and may prevent an entire herd of sick animals that require these drugs down the line.

Despite the improvements detailed in the new report, Brook said it's unclear why there are so many "holdouts" with failing grades, many of whom did not answer the groups' questions.

"These companies tend to have long-range contracts. Perhaps they're buying from recalcitrant producers," Brook suggested.

With so much variation among the top chains, she said it "points to the real need for federal policy to step in."

The US Food and Drug Administration has taken steps to limit the use of some antibiotics in food animals.

By January, animal drug manufacturers no longer allowed medically important antibiotics to be prescribed solely for growth purposes, according to the FDA. But this left open the possibility that these drugs could be used to routinely prevent disease, even if no animals were sick, so long as a veterinarian had written a prescription.

This drew criticism that the FDA's efforts didn't go far enough.

"This represents a giant loophole in FDA guidelines, which effectively do little to stop the misuse of antibiotics in animal agriculture," the authors of the new report said.

"While the FDA believes the prevention use of antimicrobials in animal agriculture can play an important role in effectively managing animal disease, it is critical that such use be judicious," the agency said in a statement.

The FDA recommends that these drugs only be given if "there are no reasonable alternatives" to prevent disease. It doesn't endorse giving these medications to "apparently healthy animals in the absence of any information that such animals were at risk of a specific disease," the agency added.

"Because (the FDA's) initiative was not fully implemented until January 2017, it is too early to speculate on how this effort may impact antimicrobial use in the animal agriculture setting," the agency said of its plan, which launched in December 2013.

Before the FDA's announcement, around 70% of "medically important" antibiotics were used in farm animals, not humans, according to data by the FDA and QuintilesIMS.

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The vast majority of these drugs used in animals are tetracyclines, a class of antibiotics that also includes treatments for chlamydia, Lyme disease and other harmful microbes in humans.

"These are drugs that are really, in plain words, important to the functioning of human medicine as we know it," said Brook.

"What I'm mostly hoping for is that this (report) ... will inspire companies to make similar commitments really quickly."