Three Days of Oral Azithromycin Versus Five Days of Oral Clarithromycin in the Treatment of Campylobacter Enterocolitis in Children: A Prospective Study
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsAn important real-world assessment of the use of azithromycin and clarithromycin antibiotics for children with Campylobacter enterocolitis is provided by this well-done study. The author suggested revising the paper based on the suggestions in order to improve the quality of the work.
Comments for author File: 
Comments.pdf
Author Response
Author's Reply to the Review Report (Reviewer 1)
Comment 1: The author recommended using a citation at the beginning or conclusion of the sentence. Creating a four- to five-line summary from the same research paper does not require citing sources at the end of each line.
Response 1: Thank you for bringing this to my attention. I have removed [1] from line 37 on Page 1 as you requested.
Comment 2: The author recommended listing the species
Response 2: Thank you for bringing this to my attention. I have added a list of species to line 38 on Page 1, as you suggested.
Comment 3: The species name needs to be italic.
Response 3: I have revised it to italics on line 41 of Page 1, as per your suggestion.
Comment 4: Why is azithromycin dosage being lowered from 10 mg to 5 mg/kg for the next two days? What are the minimal dosages of clarithromycin and azithromycin?
Response 4: I sincerely appreciate you pointing out this significant error. The correct dosage for Azithromycin is 10 mg/kg/dose, administered once daily for 3 days, and this was indeed how the study was conducted. I have corrected this on line 34 of Page 3. Additionally, there were no specified minimal dosages for clarithromycin and azithromycin.
Comment 5: Why does five days of twice-daily clarithromycin not work like azithromycin?
Response 5: This study was conducted with the expectation that a 3-day course of azithromycin and a 5-day course of clarithromycin would produce similar effects in patients with Campylobacter enterocolitis."
Commet 6: (IQR, 2.0-3.0)
Response 6: I have made the corrections to line 32 on Page 4 as per your instructions. Thank you for your guidance.
Comment 7: The author proposed that the eligibility be included in the flow chart to facilitate future study.
Response 7: Thank you for your helpful comment. In accordance with your suggestion, I have added the inclusion criteria to Figure 1.
Comment 8: The author proposed that the flow chart include a list of the rejection criteria to facilitate future study.
Response 8: Thank you for the helpful comment. As per your suggestion, I have added the exclusion criteria to Figure 1.
Comment 9: The author advised proofreading the spelling.
Response 9: I have corrected the spelling of "criteria" in Figure 1.
Comment 10: The author recommended that the dosage information and treatment duration be included in the flow chart for ease of understanding.
Response 10: Thank you for your suggestion. I have added the dosage information and treatment duration details to Figure 1.
Comment 11: Were there no female patients chosen?
Response 11: Thank you for your suggestion. I have added the 'Female' section to Table 1 as requested.
Comment 12: The author recommended sticking (IQR, 2.0-3.0) to the same format for the entire manuscript.
Response 12: I have made the correction as per your suggestion, changing (2.0 - 3.0) to (IQR, 2.0 - 3.0).
Comment 13: Illegible labeling. The author proposed making all graphs look like this.
Response 13: Thank you for the helpful feedback. I have updated Figure 2 to match the style you suggested.
Comment 14: Make it bold
Response 14: I have changed "Clarithromycin" in Table 3 to bold as requested.
Comment 15: Units?
Response 15: I have added the unit to the calprotectin section in Table 4 as requested.
Comment 16: ?
Response 16: I have deleted the incorrectly displayed section.
Comment 17: The author recommended sticking reference to the same format for the entire manuscript.
Response 17: Thank you for the helpful suggestion. I have corrected [3], [11] to [3, 11] on Page 7.
Comment 18: Italic, Italic
Response 18: I have changed "jejuni" and "coli" to italics on line 38 of Page 7.
Reviewer 2 Report
Comments and Suggestions for AuthorsThanks for giving me a chance to review. It is a good and a well written paper. It compares two antibiotics with each other and evaluates their efficacy. I have some questions and suggestions:
- Which statistical software was used for analysis? Please indicate that in the Methods section.
- When representing Lab values why are Day 3 values for clarithromycin compared? Shouldn't Day 5 values be compared as that is when the antibiotic course is considered complete.
- Can the cost of these two antibiotics be compared? Is there any scope of doing some cost benefit analysis.
- Could some sort of socioeconomic information about the patients be provided.
Author Response
Author's Reply to the Review Report (Reviewer 2)
Comment 1: Which statistical software was used for analysis? Please indicate that in the Methods section.
Response 1: I have added the relevant content to line 20 of Page 4 as requested.
Comment 2: When representing Lab values why are Day 3 values for clarithromycin compared? Shouldn't Day 5 values be compared as that is when the antibiotic course is considered complete.
Response 2: Thank you for your valuable comment. We agree that taking that approach might have provided lab values more accurately reflecting the antibiotics' effects. However, since many patients showed clinical improvement and were discharged within 5 days, we conducted follow-up on the third day of hospitalization. Nevertheless, we believe the study results still offer valuable insights into the intermediate response to treatment. We have also included a statement addressing this point in the discussion section, on page 9 lines 34-36, “Furthermore, laboratory values obtained on the third day may be too early to accurately reflect the full benefits of the antibiotics.”
Comment 3: Can the cost of these two antibiotics be compared? Is there any scope of doing some cost benefit analysis.
Response 3: Thank you for your helpful comment. We considered the potential significance of a price difference between the two antibiotics as a meaningful research outcome. However, in Korea, the cost difference is not substantial. For instance, for a 30 kg patient, a 3-day course of azithromycin costs $3.60, while a 5-day course of clarithromycin costs $3. Although prices may vary based on the patient's weight, the difference was not large enough to warrant inclusion in this study. Nonetheless, comparing the cost differences of antibiotics in future research could provide valuable insights and contribute to the advancement of the study.
Comment 4: Could some sort of socioeconomic information about the patients be provided.
Response 4: We apologize; however, we were unable to collect any information regarding the socioeconomic status of the patients.
