Feeling pressure from customers, scientists, doctors, and public health advocates, a growing number of fast food and fast-casual restaurant chains are now taking steps to eliminate at least some medically unnecessary antibiotics from the animals they source for their meat. At the same time, nearly all of these positive changes have only focused thus far on curbing antibiotic overuse in chickens, and nearly half of the industry’s biggest players still have no plan in place to deal with this issue at all.

This is according to the latest Chain Reaction report [PDF], which reviews and scores the antibiotics policies at the nation’s 25 biggest restaurant chains. The report is a joint effort of several consumer and public health advocacy groups, including the Natural Resources Council, the U.S. Public Interest Research Group, and our colleagues at Consumers Union.

Gradual Improvements

When the first Chain Reaction report came out in 2015, 80% of these restaurants earned a failing grade, with only five chains having any sort of publicly available policy for reducing or eliminating antibiotics from the food they serve.

A year later, after chains like Wendy’s, Taco Bell, and Subway made commitments to cutting back on the antibiotics used in the chickens they source, the failure rate was down to around 64%, though some of the newly passing chains — like Pizza Hut and Papa John’s — were barely beating out that “F” for only making partial promises.

As you can see from the latest scorecard on the right, a narrow majority of the 25 chains now earn passing grades, with recent additions like KFC, Starbucks, and Burger King helping to shift the balance. However, most of these passing marks are middling at best, and several of the chains that had barely passing grades last year remain C- and D students.

We should point out one thing that hasn’t changed in all of the three surveys: The only two chains to score the top grade of A have been Panera and Chipotle, both of which not only have publicly available antibiotics policies, but also source as much product from drug-free animals as possible. No other chains have been able to crack that top tier, and neither of these two has slipped.

Why The Bad Grades?

It’s easy enough to explain why the remaining “F” chains — Dairy Queen, Sonic, Olive Garden, Applebee’s, Domino’s, Chili’s, Little Caesars, Arby’s, IHOP, Cracker Barrel, and Buffalo Wild Wings — earn the low grade they do. These restaurants have zero policy for reducing the use of meat from animals raised on unnecessary antibiotics. Or if they do, they are inexplicably not telling anyone about it.

It gets more complicated for the restaurants in the “C” and “D” range of grades. Restaurants are scored on three factors: the quality of the policy they put in place; how they implement that policy; and the chain’s transparency with regard to the public about this issue.

So Starbucks gets a high score for announcing a policy intended to reduce antibiotics overuse in all the meat it serves; not just chicken. However, the coffee shop chain has not provided any sort of details or timeline for when it will actually implement its plan to reduce antibiotics in the beef or pork it buys. It also doesn’t have an auditing system in place to very this implementation. Thus: a “D+” for Starbucks.

Burger King only announced its new commitment to antibiotics reduction in June 2017, and is only focusing on chicken, so it can only get a so-so score for its policy. While the chain has given a timeline for implementing this policy, the lack of auditing and transparency further drag BK’s final grade to a “D.”

Inching Upward

A handful of chains managed to improve over their previous years’ passing grades. Subway’s policy improved by adding beef and pork to the equation, but the timeline on implementation will take so long to get there that the chain could only improve to a “B+” this year. Taco Bell jumped up from a “C-” to a “B-” for fully implementing its plan to cut out antibiotics in poultry.

KFC made the biggest leap, going from an “F” the previous two years to a solid “B-” in 2017. That’s because the chicken chain made a commitment to transition its entire product line, to being raised without medically important antibiotics by the end of 2018.

Why This Matters

Antibiotics overuse is a major contributor to the development of drug-resistant bacteria. According to the Centers for Disease Control and Prevention, some 2 million Americans fall ill with antibiotic-resistant infections each year, with more than 20,000 people dying annually as a result. Around 75% of all antibiotics sold in the U.S. go to livestock animals, primarily for the drugs’ growth-promoting effects.

This is why, say the authors of the report, that it’s so important for restaurant chains — some of the largest buyers of beef, pork, and poultry, to demand that their suppliers curb their use of medically unnecessary antibiotics, not just in chickens, but in all meat-providing animals.

“When it comes to chicken nuggets, we’ve seen incredible change in a few short years—but burgers and bacon are another story,” said Lena Brook, food policy advocate at the NRDC. “To keep our life-saving antibiotics working when people need them, the entire meat industry—beef and pork included—must start using them responsibly.”

“We must stop squandering antibiotics on animals that aren’t sick at a time when these vital medications are losing their ability to fight infections in people,” said Jean Halloran, Director of Food Policy Initiatives at Consumers Union. “Fast food restaurants have tremendous market power and should use their leverage to help address this public health crisis by ending the misuse of antibiotics.”