If you like your fast food without antibiotics, order the chicken and hold the beef and pork.
That's the advice gleaned from an annual report card published Wednesday on the fast-food and casual-dining industry, which made substantial progress this year in eliminating antibiotics from its poultry supply but lags in its efforts for beef and pork.
Use of antibiotics to raise animals is one factor behind the rise of drug-resistant infections that sicken more than 2 million people annually, causing at least 23,000 deaths, according to the Centers for Disease Control and Prevention.
Fourteen of the top 25 companies in fast food have adopted policies aimed at ridding antibiotics that are important to human health from their meat supply, according to Consumers Union and five other public-interest groups that authored the report.
The companies, which account for two-thirds of the industry's revenue, include five that adopted policies this year: KFC, Burger King, Starbucks, Dunkin' Donuts and Jack in the Box.
"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 Natural Resources Defense Council, one of the coauthors of the report.
Jean Halloran, director of food policy initiatives at Consumers Union, urged fast-food companies to "use their leverage" to push suppliers of beef and pork to reduce their use of antibiotics.
KFC, a Yum Brands company that is one of the top buyers of poultry nationwide, earned the "most improved" status, moving from a failing grade last year to a B-minus.
Perennial leaders Panera Bread and Chipotle Mexican Grill were the only companies to receive an A rating, earned because they have extended their no-antibiotics policies to pork and beef.
Subway fell just short of that top grade because its policy to rid its beef and pork supply of antibiotics was too slow, according to the report.
Meanwhile, 11 companies got failing grades for having little or no policy regarding antibiotics. Most were in the fast-casual sector, such as Olive Garden, owned by Darden Restaurants Inc., and Applebee's, owned by DineEquity Inc. Nine others flunked for not responding to the survey or not having an adequate antibiotics policy.
The shifts come in response to shareholder pressure exerted by interest groups and an increasingly demanding public that has pushed for fewer additives in their food and more humane treatment of farm animals.
Shareholder resolutions have been aimed at companies including Darden restaurants and Restaurant Brands International, owner of Burger King, Tim Horton's and Popeye's.
Consumer pressure alone won't be enough, the report card authors said. They called for federal regulation to prohibit "routine" use of antibiotics, including for disease prevention, and limits on how the medicines are used when disease breaks out in flocks and herds.
Policies adopted by companies have varied by the menu ingredient, the type of use prohibited, the class of antibiotic and the timeline for implementation.
Timeline issues kept McDonald's at last year's C-plus grade, largely because its newly expanded policy, announced last month, did not set a firm deadline for halting purchase of beef and pork raised using medically important antibiotics.
Dunkin' Donuts, meanwhile, announced a policy to eliminate all antibiotics from its chicken by 2019. Subway eliminated antibiotics from its chicken this year — and plans to do the same for its turkey, which will be antibiotic-free by 2019.
Other companies limited only "routine" use of medically important antibiotics, such as for disease prevention or promoting growth, and some had no meaningful policy at all, according to the report.
Besides Olive Garden and Applebee's, companies that earned failing grades included Dairy Queen, Sonic Drive In, Dominos, Chili's, Little Caesars, Arby's, IHOP, Cracker Barrel and Buffalo Wild Wings.
Darden's board urged shareholders in August to reject an activist resolution to phase out routine use of antibiotics, saying it would "not provide tangible benefit to shareholders or our guests and could put us at a competitive disadvantage," according to a Securities and Exchange Commission document.
"Our ingredients are carefully sourced from suppliers who share Darden's commitment to maintaining best-in-class food safety, quality, sustainability and ethical business conduct," the board wrote.
The resolution was defeated.
The meat and poultry industry has defended its use of antibiotics, saying it follows standards and procedures set by the U.S. Food and Drug Administration and Department of Agriculture.
Last year, the FDA issued several new guidelines limiting use of antibiotics to measures "considered necessary for assuring animal health" under "veterinary oversight or consultation."
Terry O'Neel, president of the National Pork Board, an industry group overseen by the USDA, said the farm animal industry no longer uses medically important antibiotics solely to promote growth. Further limiting antibiotics while maintaining animal health is "a delicate balance," he added.
"It is perplexing when others try to set arbitrary limits on antibiotic use that are actually detrimental to animal health, the environment and food safety," O'Neel said.
The North American Meat Institute, an industry advocacy group, said the use of antibiotics is declining on a per-animal basis, a sign that the industry is responding to consumer concern.
Although the CDC has pushed for decreasing the use of antibiotics on animals, the agency has focused more intently on misuse by doctors and their patients — one in three prescriptions for the drugs is not needed, the CDC found.
The most common way humans are infected with the drug-resistant superbug known as MRSA is from contact with other humans, the CDC has said.
Follow me: @LATgeoffmohan
1:15 p.m.: This article was updated with comments from meat industry groups and with additional details from the Centers for Disease Control and Prevention.