Use of macrolides, lincosamides and streptogramins (MLS) in animals in the European Union: development of resistance and impact on public and animal health - Scientific guideline

Macrolides and lincosamides are widely authorised and used in food-producing and companion animals, as well as in human medicine, where they play a critical role in the treatment of bacterial infections, particularly those affecting the respiratory tract and soft tissues.

Streptogramins are not currently authorised for veterinary use in the EU, and are only scarcely used in human medicine within the EU. However, owing to their shared sites of action and resistance mechanisms, these antimicrobial classes were reviewed together. 

The updated reflection paper provides a comprehensive review of the use of MLS within the EU, examining their pharmacological properties, patterns of use, the development of resistance, and the resulting public, animal, and environmental health implications. It also identifies the need for animal and environmental risk management measures, highlights knowledge gaps, and suggests areas for further research.

Keywords: Antibiotics, antimicrobials, macrolides, lincosamides, streptogramins, ketolides, antimicrobial resistance, animals, veterinary medicine

Current version - Revision 1

Draft reflection paper on the use of macrolides, lincosamides and streptogramins (MLS) in animals in the European Union: development of resistance and impact on public and animal health - Revision 1

Draft: consultation open Consultation dates: 24/04/2026 to 31/08/2026 Reference Number: EMA/CVMP/AWP/741087/2009 Rev. 1 Summary:

Comments should be provided using this template. The complete comments form should be sent to [e-mail] 

Document history

Concept paper on an update to the CVMP’s reflection paper on the use of macrolides, lincosamides and streptogramins (MLS) in food-producing animals in the European Union: development of resistance and impact on human and animal health

Draft: consultation closed Consultation dates: 15/10/2021 to 31/01/2022 Reference Number: EMA/CVMP/AWP/266787/2021

Reflection paper on the use of macrolides, lincosamides and streptogramins (MLS) in food-producing animals in the European Union development of resistance and impact on human and animal health

Adopted Reference Number: EMA/CVMP/SAGAM/741087/2009

Overview of comments received on reflection paper on the use of macrolides, lincosamides and streptogramins (MLS) in food-producing animals in the European Union: development of resistance and impact on human and animal ...

Reference Number: EMA/CVMP/SAGAM/358728/2011

Reflection paper on the use of macrolides, lincosamides and streptogramins (MLS) in food-producing animals in the European Union: development of resistance and impact on human and animal health

Draft Reference Number: EMA/CVMP/SAGAM/741087/2009

Concept paper on the use of macrolides, lincosamides and streptogramins in food-producing animals in the European Union: development of resistance and impact on human and animal health

Reference Number: EMEA/CVMP/SAGAM/113420/2009