There is a huge burden of penicillin allergy labels (PALs) and up to95% of PALs are inaccurate.1–3 There is an unmet need for allergyspecialists, particularly in low- middle income countries (LMICs),where there are alarming rates of antimicrobial resistance (AMR). 4,5A relatively simple method of risk stratification by non-allergyhealthcare professionals (HCPs) employing a computerised decisionsupport system (CDSS) has been successfully employed in the con-text of penicillin allergy de-labelling.6The aim of this study was to gain insights into drug allergy man-agement pathways as well as the views and perspectives of HCPsregarding drug allergies in Sri Lanka, Barbados, Trinidad and Tobagoand Egypt. Drug allergy management pathway refers to the systems,framework and governance underpinning drug allergy labelling andde-labelling including mechanisms of documentation and counsellingof patients, referral pathways to an allergy specialist and conductingroot cause analysis of serious and/or near-miss adverse drug events.Synchronous virtual focus group discussions were conductedusing an on-line video platform. The topic guide was designed by theinvestigators from participating countries. The study is reported inaccordance with the ‘consolidated criteria for reporting qualitativeresearch’ (COREQ) checklist. Approval was obtained from institu-tional review boards in participating centres.