A joint report from six consumer and environmental groups has graded the top 25 fast-food chains on the use of antibiotics in the burgers they sell. Bad news for 22 of them: They received a failing grade.

The restaurants that failed include McDonald’s, Burger King, Sonic, Jack In The Box, Hardee’s, Whataburger, Carl’s Jr., White Castle, The Habit Burger Grill, Fuddruckers, and In-N-Out Burger.

The overuse of antibiotics in animals is accelerating the rise of bacteria that are resistant to such medicines, according to the World Health Organization, which considers antibiotic resistance “one of the biggest threats to global health, food security, and development today.” According to the Centers for Disease Control, 2 million Americans get an infection from such bacteria each year, with 23,000 of those cases leading to death.

The report, titled Chain Reaction, was produced in cooperation with Consumer Reports, Center for Food Safety, U.S. PIRG Education Fund, Food Animal Concerns Trust, Friends of the Earth, and the Natural Resources Defense Council.

More than 70% of the medically important antibiotics sold in the U.S. go to food animals,” the report said. “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 production practices.”

Only two chains, Shake Shack and BurgerFi, received an A grade for sourcing meat that was raised without the routine use of antibiotics. Wendy’s received a D minus after sourcing 15% of its beef from suppliers that use less tylosin, a key antibiotic.

A 2018 survey from Consumer Reports found that 59% of those surveyed indicated a preference for eating at restaurants that serve meat from animals raised without antibiotics.

A McDonald’s spokesperson told USA Today that the company would announce a new global antibiotics policy by the end of this year.