A narrative review argues that most patients labeled penicillin-allergic are not truly allergic and that delabeling should move to routine antimicrobial stewardship using PEN-FAST and direct oral challenge. The piece emphasizes streamlined workflows to reduce unnecessary avoidance of beta-lactams. The recommendation targets a longstanding clinical bottleneck: inaccurate allergy labels drive broader-spectrum antibiotic use, higher costs, and potentially worse outcomes. Implementing structured risk stratification could standardize when clinicians safely challenge patients. The review aligns stewardship with practical risk assessment, aiming to turn allergy documentation into a modifiable safety and quality lever.