Chain Reaction VI

How top restaurants rate on reducing antibiotic use in their beef supply chains

michaelform via Pixabay and Mike Mozart via Flickr, CC BY 2.0

The Chain Reaction VI report and scorecard ranks America’s top restaurant chains on their policies relating to antibiotic use in their beef supply chains. The overuse of antibiotics on industrial farms contributes to antibiotic-resistant bacteria, which can cause life-threatening infections in people. We need our life-saving medicines to work, and because fast food companies are some of the largest buyers of meat, they are uniquely positioned to address this public health crisis.




The growth and spread of antibiotic-resistant bacteria is a global health crisis, threatening to create a future in which common infections could once again become life-threatening on a large scale. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) consider antibiotic-resistant bacteria among the top threats to global public health, and the CDC estimates that each year, at least 35,000 Americans die from resistant infections.[1] Another estimate suggests it could be seven times as many, accounting for more than 160,000 annual deaths.[2]

The overuse of antibiotics in livestock production significantly contributes to the spread of antibiotic resistant bacteria.[3] The more antibiotics are used, the more opportunities resistant bacteria have to multiply and spread. Approximately two-thirds of the medically-important antibiotics sold in the United States go to food animals.[4],[5],[6] Many meat producers routinely give the drugs to animals that are not sick to prevent diseases caused by factory farm production practices.[7] Despite the threat posed to public health, the U.S. lacks effective laws and policies to prevent the overuse of antibiotics in agriculture.

Fast food restaurants, as some of America’s largest meat buyers, can play an instrumental role in pushing meat producers to use antibiotics responsibly. In fact, previous editions of Chain Reaction have documented how the nation’s top restaurant chains have stepped up their commitments to source chicken from producers that raise animals without the routine use of antibiotics.[8] These corporate actions have helped move the chicken industry toward more responsible antibiotic use practices. According to an industry survey, almost all of U.S. broiler chickens in 2020 were raised without the routine use of medically important antibiotics as defined by the Food and Drug Administration.[9]



Consumers want restaurants to serve meat raised without the routine use of antibiotics. For instance, in a nationally representative 2018 survey of 1,014 adults conducted by Consumer Reports, 59 percent of those polled indicated that they’d be more likely to eat at a restaurant that served meat raised without antibiotics — and more than half agreed that restaurants should stop serving meat and poultry raised with antibiotics.[10]

Although there is massive progress in the chicken industry in response to such consumer demand, many fast food restaurants have failed to make meaningful commitments to address antibiotic overuse in their beef supply chains this year. One notable exception is Wendy’s, which committed to ending the routine use of medically-important antibiotics in its U.S. and Canadian beef supplies by the end of 2030 [11]. McDonald’s, on the other hand, failed to meet its own deadline for setting reduction targets in its beef supply last year. This is concerning because in 2019, the beef sector accounted for 41 percent of the medically-important antibiotics sold to the meat industry.[12]


Fast food can have a significant impact on antibiotic use in the beef industry

This year’s Chain Reaction report and scorecard therefore focuses on antibiotic use policies and practices for beef sold in the top U.S. fast food and fast casual chains.

Burger chains especially have a crucial role to play in reducing antibiotic use. To protect public health and push the beef industry to eliminate the overuse of antibiotics, restaurants — especially burger chains — should commit to sourcing beef from producers that use antibiotics under the guidance of a licensed veterinarian, and only to treat animals diagnosed with an illness or in limited circumstances to control a verified disease outbreak. So far, however, few have done so.

Our survey showed that only two chains, Chipotle and Panera Bread, currently source a significant amount of beef raised without the routine use of antibiotics. Applebee’s and IHOP source a small fraction of beef raised under that policy. Wendy’s jumped from a D+ to a C this year for its new commitment to prohibit the routine use of medically-important antibiotics in its beef supplies by the end of 2030. It’s a major step forward for the third largest burger chain, and as long as the company implements that commitment its grade will continue to improve. Most other chains have no established policy restricting antibiotic use in their beef supply chains.

Shortly after Chain Reaction IV was released, McDonald’s announced a commitment to monitor and reduce medically-important antibiotic use in its beef supply. This action by the nation’s largest beef purchaser bumped McDonald’s from an F to a C in Chain Reaction V. However, the company failed to meet its own deadline of setting targets for reducing medically-important antibiotic use by the end of 2020, so it remained at a C in this year’s report.


Policymakers should act to protect public health

While restaurants and major meat producers have critical roles to play in stopping the overuse of antibiotics, the government must also act to achieve the kind of lasting, industry-wide change needed to fully protect public health.

Policymakers should only allow beef producers to use medically-important antibiotics under the guidance of a licensed veterinarian, and to treat animals diagnosed with an illness or to control a verified disease outbreak. Policymakers should also set national goals for reduction of antibiotic use in food animals, and dramatically improve collection and disclosure of antibiotic use data. Comprehensive policy reforms will ensure that all meat producers across the U.S. meet the same responsible antibiotic use standards. These reforms are vital to preserving life-saving medicines for the future health of both animals and people.




[1] U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC from here on), Antibiotic Resistance Threats in the United States, 2013,

[2] Journal of Infection Control and Hospital Epidemiology, New Estimate of Annual Deaths Caused by Treatment Resistant Infections Highlights Gaps in Research, Stewardship, Surveillance3 December 2018,–publications-new/articles/2018/new-estimate-of-annual-deaths-caused-by-treatment-resistant-infections-highlights-gaps-in-research-stewardship-surveillance/

[3] World Health Organization, World Health Organization (WHO) Guidelines on Use of Medically Important Antimicrobials in Food-producing Animals, 17January 2018,; CDC, Antibiotic Resistance from the Farm to the Table (infographic), 2013,

[4] U.S. Food and Drug Administration (hereinafter FDA), Center for Veterinary Medicine, 2016 Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals, December 2017, Data on 2015 sales of antibiotics for human medicine in the United States were obtained from Eili Klein of the Center for Disease Dynamics, Economics & Policy (CCDEP). Klein also provided data for years prior to 2015 in Kar, A., and Klein, E. “Animal Antibiotic Sales Finally Drop, but Much Work Remains,” Natural Resources Defense Council (hereinafter NRDC), December 2017, CDDEP also provided those figures for years preceding 2015; 2016 data are not yet available.

[5] Natural Resources Defense Council, Livestock Antibiotic Sales See Big Drop, but Remain High, 18 December 2018,

[6] “Medically-important antibiotics” or “antibiotics important to human medicine” refers to antibiotics that are the same as, or similar to, classes of drugs used in human medicine. For example, the antibiotic tylosin, used in livestock, is a member of the medically-important macrolide class of antibiotics. Throughout this report, we will use the term “antibiotics” and “medically-important” antibiotics interchangeably, unless otherwise noted.

[7] Timothy F. Landers et al. “A Review of Antibiotic Use in Food Animals: Perspective, Policy, and Potential,” U.S. National Library of Medicine National Institutes of Health ,127(1): 4–22, Jan-Feb 2012,; “prevent disease caused by factory farm production practices” refers to routine antibiotic use ostensibly to prevent disease in healthy animals, rather than safer, non-antibiotic animal management alternatives.

[8] Antibiotics Off the Menu, Scorecards, accessed at, 30 September 2018; Here and throughout, “meat raised without the routine use of antibiotics” refers both to meat raised entirely without antibiotics and meat raised without routine uses of antibiotics on animals that are not sick. Report authors support the use of antibiotics to treat sick animals.

[9] “Poultry Health Today, No-antibiotics-ever production slips, but US producers remain committed to reducing antibiotic use, 14 May 2021,

[10]  Consumer Reports, Natural and Antibiotics Labels Survey Report, 1 May 2018.

[12] FDA, Center for Veterinary Medicine, 2019 Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals, December 2020,