Barriers and Facilitators Affecting Long-Term Antibiotic Prescriptions for Acne Treatment

JAMA Dermatology

Clinical Summary

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What was studied

A qualitative study used an online survey and semistructured video interviews (March–August 2021) with stakeholders (dermatologists, infectious disease physicians, dermatology residents, and nonphysician clinicians) to identify barriers and facilitators to long-term oral antibiotic prescribing for acne, analyzed with the Theoretical Domains Framework.

Key findings

Among 30 participants (14 males, 16 females), guideline knowledge was high and antibiotic stewardship was viewed as a professional duty; five themes shaping long-term antibiotic use emerged: perceived lack of evidence to change dermatologic practice, patient demand and satisfaction pressures, discomfort discussing contraception, iPLEDGE-related barriers, and lack of systems to measure stewardship progress.

Clinical implications

Design outpatient dermatology antibiotic stewardship for acne to directly address clinician perceptions of evidence, patient expectations, contraception conversations, iPLEDGE hurdles, and to include mechanisms to track stewardship progress.