SALT LAKE CITY — When Ron Hunt gets that wracking cough and under-the-weather feeling, he knows what it means: bronchitis.
It's like clockwork every year: Hunt starts coughing. He goes to his doctor. His doctor prescribes antibiotics.
After a few days, Hunt said, he usually feels better.
Hunt said that although he doesn't believe the five-day oral antibiotics like Z-Pak are a "cure-all magical drug," they do help him.
"While there can certainly be a case made for people who are overprescribing or overusing antibiotics, in this case, for me, I follow the instructions of the doctor and it works," Hunt said.
Many public health officials, however, are now urging doctors to avoid prescribing antibiotics for illnesses usually caused by viruses — like bronchitis. They say that doing so is driving the rise of "superbugs" — drug-resistant bacteria like MRSA that now kill tens of thousands of people every year in the U.S.
Yet many doctors continue to do so, including in Utah.
A report published last week by the Utah Department of Health shows the average Utah clinic with 10 or more patients prescribes antibiotics for acute bronchitis 62 percent of the time.
Some, like Holladay Family Practice in Salt Lake City, prescribed antibiotics to 88 percent of its 68 acute bronchitis patients.
Other clinics, like the Intermountain Rose Canyon Clinic in Riverton, prescribed antibiotics to just one of its 23 bronchitis patients.
"It's not a new thing," said Norman Thurston, the director of the Office of Health Care Statistics, and a Utah House representative. "But we're naming names. In fact, this is the first time we've actually named names."
The statistics come from a little-known repository of Utah medical and pharmacy claims data known as the All Payer Claims Database. Legislators charged the Utah Department of Health with building and overseeing the database — which includes tens of millions of insurance claims — in 2008.
The idea was to arm consumers with information about how much insurers are charging for tests or procedures and allow them to comparison shop.
But the office has had difficulty organizing the complex and often disjointed data that must be scrubbed, matched and reformatted to be useful, Thurston said.
According to Thurston, the office would like to create a program so that people can find the answers to dozens of medical questions, including how much a procedure costs at different hospitals or how well a clinic is performing on a certain metric. But he said that likely wouldn't be anytime soon.
"It's just very expensive and very time-consuming," Thurston said. "Those kinds of things are like the holy grail of claims data. We'll get closer over time, but that is a fairly complicated question."
The health department's report also looks at which clinics are regularly checking on their patients' diabetes using something called the hemoglobin A1c test.
The data showed that testing rates were high across all clinics and that 68 clinics had a 100 percent testing rate.
It took about a year to complete the two analyses, Thurston said.
People can visit the list here to search for their clinic’s ranking.
The analysis includes 232 large clinics by name and is based on data from 2013 and 2014, Thurston said. Small clinics with fewer than five physicians are not listed by name.
"We think that quality transparency, clinic by clinic, helps," Thurston said. "We have a phrase that we use all the time, which is, 'There's no antiseptic like a little sunshine.'"
According to experts, many doctors prescribe antibiotics out of habit. Others say it's hard to send patients home empty-handed, or that they feel obligated to play it safe if there's even a small chance the infection could be bacterial.
Thurston hopes the report spurs doctors who are overprescribing to ask how others are managing their bronchitis care.
"Medicine is competitive, but it's also cooperative," Thurston said.
MountainStar's primary care group at Ogden Regional Medical Center prescribed antibiotics to more than three-quarters of their 98 bronchitis patients, according to the report.
Dr. Robert Mohr, an internal medicine doctor with the group, said in a statement that he supports efforts to cut back on antibiotic use.
"We appreciate the Utah Department of Health’s work to address this issue in our state," Mohr said, adding that the group would weigh the data against the fact that many of the group's patients are in hospice care or nursing homes and are at risk of pneumonia.8 comments on this story
"Of course, we will adjust our prescribing practices if necessary while continuing to appropriately take care of all our patients," Mohr said.
Four Intermountain Healthcare clinics topped the list of clinics that managed to avoid prescribing antibiotics for bronchitis most often.
Last year, the health system signed on to a national effort to fight antibiotic overuse, led by the White House. As part of that effort, Intermountain pledged to reduce outpatient antibiotic use for upper respiratory conditions in half by 2020.