Table 2. Capability-Related to Salient Barriers or Facilitators to Antibiotic Stewardship in Acne Treatment.

Domain and theme	Representative quote (participant No., male/female [M/F], degree, role)
Knowledge
Lack of evidence in the dermatologic literature	“I think the mounting evidence of resistance is huge [but] it’s not in the dermatologic literature necessarily.” (9, F, MD, dermatology resident)
Skills
Navigating patient discussions about tapering antibiotics	“Antibiotic resistance doesn’t really have a face or a way of really identifying it. So, as with a lot of things in public health, when you have a patient in front of you who’s like, ‘This is really debilitating. I have a real problem with this. Why can’t you give me more of this?’ It puts the provider under a lot of pressure and a bad place to be able to say no. It’s a lot easier to say yes than it is to say no.” (17, M, MD, infectious diseases attending physician) “I guess the main conflict would be if the antibiotic was working while the patient was on it, and then it’s withdrawn because of the treatment duration limitation. Then that would be a conflict, because the patient’s going to say, ‘Well, it’s working. Why can’t I just stay on it?” (16, F, MD, dermatology attending physician)
Discomfort with contraceptive discussion	“The first-line therapy for [women] would be OCPs [oral contraceptive pills]. However, the term ‘contraceptive’ has some connotations. And so, there’s some reluctance among some of my women patients.” (1, M, MD, dermatology attending physician)
Clinical inertia	“…probably two-thirds or more know how to do it, but they’re just, they’re lazy. They take the path of least resistance.” (19, M, MD, dermatology attending physician)
Using antibiotics as bridge therapy	“I’ll tell them that the goal is to come off the antibiotics in three months and just be maintained on the cream and the wash.” (30, F, MD, dermatology attending physician)