Contribution of antimicrobials to the development of allergic disease

[Display omitted] •Exposure to antimicrobial agents is associated with an increased incidence of allergic disease.•Exposure to antimicrobial agents can induce diverse immunological mechanisms.•The exposure microenvironment can influence the sensitization response to antimicrobials.•Antimicrobials can disrupt the microbiome, indirectly influencing the development of allergic disease.•Additional research is needed to fully understand mechanisms of antimicrobial sensitization. Antimicrobials represent a broad class of chemicals with the intended purpose of eliminating or controlling the growth of harmful microorganisms. Exposure can occur occupationally or through the use or consumption of consumer products. The use of antimicrobial agents has been associated with an increased incidence of allergic diseases, including asthma, atopic dermatitis, and less commonly, anaphylaxis. Very diverse immunological mechanisms and mediators have been identified in the sensitization response to antimicrobial chemicals and the importance of the local microenviroment in the response is increasingly being recognized. A complete understanding of the mechanisms of allergic diseases resulting from antimicrobial exposure will help to ensure safe environments and exposure limits.