Table 2.

Themes and quotations from primary care physicians regarding drivers antibiotic prescribing

Themes	Quotations
Attribution of inappropriate antibiotic prescribing to others	‘I think those of us who have our own practice and control of things probably(…)‘get it’ more than the hourly non-vested person in your walk-in clinics who are just basically drawing an hourly salary and their whole interest is in just getting rid of somebody.’ – Birmingham, family medicine/internal medicine physician ‘We’re always practicing evidence-based medicine, so it becomes incredibly challenging. With adult medicine, they’ll give out antibiotics over the phone, antibiotics without doing swabs and chest X-rays, things like that, or even seeing the patient.’ – Chicago, paediatrician ‘A lot of us don’t like to prescribe antibiotics, but they go to urgent cares and they go to(…)1 min clinics and they get prescribed antibiotics.’ – Los Angeles, family medicine/internal medicine physician
Patient demand as a driving factor	‘We’re under pressure all day. You don’t want to get written up, potentially, for being insensitive, or not taking care of them, or physician ratings.’ – Birmingham, paediatrician ‘They come in and it’s a boxing match. You are fighting in that corner with the misconception, preconceived notion and you’re trying to tell them that 2+2 = 4 and they are saying’, ‘No, it’s purple’. – Birmingham, family medicine/internal medicine physician ‘Sometimes you just like, you know what, I’m beaten down; so, here’s your Z-Pak. See you. Next patient. I’m not going to sit here and argue with somebody for 5 min over why they don’t need it.’ – Philadelphia, family medicine/internal medicine physician