Inaccurate penicillin allergy labels (PALs) are a major public health problem in high-income countries and has been linked to antimicrobial resistance (AMR) and huge healthcare costs. Data regarding epidemiology of PALs and its potential association with AMR is sparse in low-income countries (LICs), low-middle-income countries (LMICs) and upper-middle-income countries (UMICs). There are no established drug allergy labelling and delabelling pathways in the majority of the LICs, LMICs and UMICs and addressing these inequities is critical for safe clinical practice and in the global campaign against AMR. A standardised validated computerised decision support tool might help address these gaps, but understanding local factors including clinical governance, cultural, social, religious and human behaviour will be key to uptake and success of such an intervention.