A new report highlights how “many meat producers routinely give the drugs to animals that are not sick," and how well major burger chains monitor their beef supply for the presence of antibiotics. Most don't, it said.

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Most major hamburger restaurant chains don’t monitor their beef suppliers to ensure they aren’t over-injecting cows with antibiotics, raising the risk of spreading drug-resistant bacteria in humans, according to a new report. Shake Shack and Burgerville, which have locations in Washington, are among the few exceptions.

The study, conducted by U.S. Public Interest Research Group (PIRG), was released Wednesday. It uses a traditional A to F grading scale to compare the antibiotic-use policies of the biggest 25 chains in the country. McDonald’s, Hardee’s, Burger King and Five Guys were among 22 restaurant chains that received an F. Wendy’s got a D-, while Shake Shack and BurgerFi earned an A. Burgerville’s rules received an honorable mention, along with other smaller restaurants cited by the report.

In 2016, about 70 percent of antibiotics used in the U.S. were administered to animals, with the majority of those going to cows, according to Federal Drug Administration data. When used to treat disease, the practice is acceptable as long as the animal is allowed time for the drugs to work out of its system before it’s slaughtered. It’s the use of antibiotics to promote growth in farm animals that poses a public-health risk, one which the FDA says it’s fighting to eliminate.

Overusing antibiotics allows for more bacteria to develop antibiotic resistance, considered by the CDC in 2013 as “one of the biggest public health challenges of our time.” Antibiotic-resistant bacteria from the agriculture industry can reach humans in a variety of ways, from water runoff to dust in the wind to spoiled or poorly prepared food.

The report highlights how “many meat producers routinely give the drugs to animals that are not sick either to promote faster growth or to prevent disease caused by factory farm practices.”

The report’s main authors are Matthew Wellington and Shelby Luce of PIRG Education Fund. The group describes itself as “federation of independent, state-based, citizen-funded organizations that advocate for the public interest.” PIRG has several ongoing campaigns including a campaign to stop the overuse of antibiotics.

The group graded burger chains based on three categories: policy, implementation and transparency. All chains that got an F reported no policy for antibiotic use in their beef supply that is consistent with World Health Organization guidelines. Just seven of the 25 chains completed and returned the report’s survey regarding antibiotic use.

“The beef industry, as we know it now, has been built around routine antibiotic use,” Wellington, who heads PIRG’s effort to stop overuse of antibiotics, said in a phone interview. “Without changing conditions, it is hard for the beef industry to reduce their use. I think, for a long time it has been business as usual.”

Burgerville, a chain based in Vancouver, Washington, with about 45 locations in the southwestern part of the state and in Oregon, was among seven smaller companies that the report cited as using beef not treated with antibiotics. Others include Burger Lounge in California, Good Times in Colorado and Epic Burger in Chicago.