One Health Resource Center

One Health Resource Center

Issue: December 2019
November 23, 2019
3 min read

Bad grades for antibiotic use in beef show ‘drastic changes’ still needed in US restaurants

Issue: December 2019
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Raghavendra Tirupathi, MD, FACP
Raghavendra Tirupathi

As was recently reported in the fifth edition of the Chain Reaction report, more than a dozen of the top 20 restaurant chains in the United States received failing grades for antibiotic use in beef — a sign that the industry must expand its commitment to address the overuse of antibiotics, experts suggested.

“The overuse of antibiotics in livestock significantly contributes to the rise and spread of antibiotic resistance,” said Infectious Disease News Editorial Board Member Raghavendra Tirupathi, MD FACP, medical director of Keystone Infectious Diseases/HIV, chair of infection prevention at Summit Health and clinical assistant professor of medicine at Penn State University School of Medicine.

“Many meat producers routinely give drugs to animals that are not sick to help them survive the unsanitary conditions on factory farms. Fast food restaurants, as some of America’s largest meat and poultry buyers, have played an instrumental role in pushing producers to use antibiotics responsibly and can leverage their buying power in support of better practices.”

Chain Reaction is an annual report and scorecard that ranks U.S. restaurant chains on their policies regarding antibiotic use in meat supply chains. The latest edition ranked 20 popular restaurants, including top fast-food chains, on their policies regarding beef.

Many of the fast food restaurants in the U.S. have failed to make commitments to address antibiotic overuse in their beef supply chains.
Source: Adobe Stock.

According to the report, the top performers included Chipotle and Panera Bread, which earned A and A- grades, respectively, for the fifth year in a row.

“We are extremely proud that our commitment to food with integrity is being recognized for leading the restaurant industry with top animal welfare standards,” Chipotle Chief Corporate Reputation Officer Laurie Schalow told Infectious Disease News.

Sara Burnett, vice president of Wellness and Food Policy at Panera, said the chain has “been committed to responsible antibiotic use since 2004.”

“As an early adopter, we helped prove that responsible sourcing can be done at scale while adhering to sustainable production practices. We are proud of this recognition and hope the industry follows suit on a path towards sourcing responsibly raised beef,” Burnett said.

No chain received a B grade. McDonald’s, Wendy’s and Taco Bell received C, D+ and D grades, respectively. All the rest — Applebee’s, Burger King, Olive Garden and Starbucks among them —received failing grades.

“Some restaurants like McDonalds” — which upgraded from an F to C grade and received the report’s “Biggest Mooover” award — “have made major strides in the sourcing of their beef this year, but most big and influential chains lack transparency in reporting,” Tirupathi said. “It is important to note that in 2017, cattle accounted for 42% of all medically important antibiotics sales to the U.S. livestock industry. This slow pace of change is especially troubling.”


He said there is an urgent need for compliance with WHO’s 2017 guidelines on the use of medically important antibiotics in food animals, with an emphasis on restricting use of antibiotics to sick animals under the direct oversight of a veterinarian.

“Antibiotics should not be used for growth promotion or routine disease prevention purposes,” he said.

Ramanan Laxminarayan, PhD, founder and director of the Center for Disease Dynamics, Economics & Policy, agreed that transparency within the industry is key for accountability, noting that reports like this are helpful to inform people — from customers to shareholders — about the action or inaction of food restaurants to reduce antibiotic use in their supply chains.

“Though commendable efforts have been made by a few top restaurant chains, the overwhelming number received a failing grade, indicating the need for swifter, more extensive action across the industry,” he said. “Sustained and increased consumer pressure is crucial, as are policy reforms that increase transparency and are comprehensive to ensure that all U.S. meat producers meet the same judicious antibiotic use standards.”

According to Laxminarayan, regardless of the low grades, significant changes are occurring in the U.S., including consumer preference for meat not treated with antibiotics, leading to companies to reduce antibiotic use in animals. Despite this, and even though the FDA banned the use of antibiotics for growth promotion and food efficiency in 2017, resistance is still spreading at an alarming rate.

“[This indicates] the need for more drastic changes,” he added.

“If we are to slow the antibiotic resistance crisis, all sectors and industries must be committed to making a meaningful impact on reducing the overuse and misuse of antibiotics,” Laxminarayan said. “As key actors in the beef supply chain, fast food restaurants are uniquely poised to pressure the livestock industry by only sourcing meat from producers who use antibiotics strictly under veterinary oversight. However, as this report shows, the majority of the top restaurant chains are woefully underperforming.” – by Caitlyn Stulpin


U.S. Public Interest Research Group. Chain Reaction V. Accessed November 20, 2019.

Disclosures: Laxminarayan and Tirupathi report no relevant financial disclosures.