Objective To analyze the cognition level of health care workers (HCWs) and the management status of various levels of medical institutions towards allergy reactions to commonly used antimicrobial agents. Methods HCWs and clinical pharmacists who were related to the diagnosis and treatment of antimicrobial agents in 14 medical institutions of city-level and autonomous prefectures in Gansu Province were randomly selected for a questionnaire survey. The survey contents included respondents' basic information, criteria for judging antimicrobial allergy, awareness on procedures related to antimicrobial allergy, and antimicrobial management level of different levels of medical institutions. Results A total of 8 670 valid questionnaires from HCWs were collected, including 3 300 physicians, 5 024 nurses and 328 pharmacists. 160, 775, 2 123 and 5 612 HCWs were with senior, associate, intermediate and junior professional titles, respectively. 87.66% of the HCWs received relevant training on antimicrobial management in the past two years, the proportion of HCWs from different levels of medical institutions who have received training on antimicrobial management in the past two years was statistically significant different(χ²=42.668, P < 0.001). HCWs with senior professional titles had the highest proportion of receiving relevant training (93.75%), there was a statistically significant difference in the proportion of receiving antimicrobial management training among HCWs with different professional titles in the past two years(χ²=69.782, P < 0.001). 50.98% of HCWs were not clear about penicillin allergy, and most of whom were with junior professional titles, accounting for 68.52%. 25.19% of HCWs expressed uncertainty about whether patients with penicillin allergy could use cephalosporins, 225 of whom were with associate professional titles, accounting for 29.03% of the total number of HCWs with associate profe-ssional titles. 6.11% of HCWs had no experience in skin test procedure; 46.94% of HCWs expressed that their medical institutions had no or unclear about whether their medical institutions had an antimicrobial allergy assessment team. Conclusion HCWs' judgment on allergy reactions to commonly used antimicrobial agents and awareness on antimicrobial application is not high enough, and the overall management level of antimicrobial allergy in all levels of medical institutions is poor. The popularity of antimicrobial allergy assessment teams is not high, and there is an urgent need to strengthen supervision, management, training, et al.