Reviewer’s report
Title:  Cefuroxime,  levofloxacin,  esomeprazole,  and  bismuth  as  first-line  Helicobacter  pylori  
eradication therapy in patients allergic to penicillin
Version: 2 Date: 17 Apr 2019
Reviewer: Chao-Hung Kuo
Reviewer's report:
I appreciate the satisfying eradication results from this regimen. The data is promising but there are  
revisions and discussions that should be added in order to make your article more complete.
1.Many  literatures  have  proved  that  the  previous  treatment  experience  would  affect  the  
eradication rate, probably related to secondary antibiotics resistance from previous treatment.  
Therefore,  I  suggest  that  in  your  table  1,  baseline  factors  should  include  the  treatment  
experience such as Tx-naïve or Tx-experienced. Also , this factor should be added into uni and  
multi variate analysis.
2.There's s minor misspelling of Rapid urease test in Page 8, line 10,
3.In your table 3, multi-variates analysis should be expressed in your table with p value. It's more  
important than uni-variate analysis.
4.In China, Bismuth-containing quadruple therapy (Bismuth, metronidazole, tetracyline and PPI)  
is widely used and generally recommended. Due to lack of control group in your study design, I  
suggest  that  you  should  compare  your  results  with  the  real-world  eradication  data  of the  
currently common regimen in your area. If your proposed regimen show higher eradication rate  
than  the  locally  recommended  regimen,  your  result  would  be  more  promising  and  more  
convincing. Local eradication data and local antibiotics resistance data is very important when it  
comes to H pylori treatment and therefore, you should add more local data in your discussion  
part.
5.Levofloxacin has been recommended and reserved as the 2nd line therapy by many guidelines.  
Could you please share your thoughts on the 2nd line therapy if the patients fail with this CLEB  
regimen. Your point of view will affect feasibility of CLEB regimen is real-world practice.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional  
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further  
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If  
your reply is yes to any, please give details below.
I declare that I have no competing interests
I agree to the open peer review policy of the journal. I understand that my name will be included on my  
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not  
be published.
I agree to the open peer review policy of the journal
Reviewer’s report
Title:  Cefuroxime,  levofloxacin,  esomeprazole,  and  bismuth  as  first-line  Helicobacter  pylori  
eradication therapy in patients allergic to penicillin
Version: 2 Date: 17 Apr 2019
Reviewer: Chao-Hung Kuo
Reviewer's report:
I appreciate the satisfying eradication results from this regimen. The data is promising but there are  
revisions and discussions that should be added in order to make your article more complete.
1.Many  literatures  have  proved  that  the  previous  treatment  experience  would  affect  the  
eradication rate, probably related to secondary antibiotics resistance from previous treatment.  
Therefore,  I  suggest  that  in  your  table  1,  baseline  factors  should  include  the  treatment  
experience such as Tx-naïve or Tx-experienced. Also , this factor should be added into uni and  
multi variate analysis.
2.There's s minor misspelling of Rapid urease test in Page 8, line 10,
3.In your table 3, multi-variates analysis should be expressed in your table with p value. It's more  
important than uni-variate analysis.
4.In China, Bismuth-containing quadruple therapy (Bismuth, metronidazole, tetracyline and PPI)  
is widely used and generally recommended. Due to lack of control group in your study design, I  
suggest  that  you  should  compare  your  results  with  the  real-world  eradication  data  of the  
currently common regimen in your area. If your proposed regimen show higher eradication rate  
than  the  locally  recommended  regimen,  your  result  would  be  more  promising  and  more  
convincing. Local eradication data and local antibiotics resistance data is very important when it  
comes to H pylori treatment and therefore, you should add more local data in your discussion  
part.
5.Levofloxacin has been recommended and reserved as the 2nd line therapy by many guidelines.  
Could you please share your thoughts on the 2nd line therapy if the patients fail with this CLEB  
regimen. Your point of view will affect feasibility of CLEB regimen is real-world practice.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional  
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further  
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If  
your reply is yes to any, please give details below.
I declare that I have no competing interests
I agree to the open peer review policy of the journal. I understand that my name will be included on my  
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not  
be published.
I agree to the open peer review policy of the journal
Please review this paper.
user
Reviewer’s report
Title:  Cefuroxime,  levofloxacin,  esomeprazole,  and  bismuth  as  first-line  Helicobacter  pylori  
eradication therapy in patients allergic to penicillin
Version: 2 Date: 17 Apr 2019
Reviewer: Chao-Hung Kuo
Reviewer's report:
I appreciate the satisfying eradication results from this regimen. The data is promising but there are  
revisions and discussions that should be added in order to make your article more complete.
1.Many  literatures  have  proved  that  the  previous  treatment  experience  would  affect  the  
eradication rate, probably related to secondary antibiotics resistance from previous treatment.  
Therefore,  I  suggest  that  in  your  table  1,  baseline  factors  should  include  the  treatment  
experience such as Tx-naïve or Tx-experienced. Also , this factor should be added into uni and  
multi variate analysis.
2.There's s minor misspelling of Rapid urease test in Page 8, line 10,
3.In your table 3, multi-variates analysis should be expressed in your table with p value. It's more  
important than uni-variate analysis.
4.In China, Bismuth-containing quadruple therapy (Bismuth, metronidazole, tetracyline and PPI)  
is widely used and generally recommended. Due to lack of control group in your study design, I  
suggest  that  you  should  compare  your  results  with  the  real-world  eradication  data  of the  
currently common regimen in your area. If your proposed regimen show higher eradication rate  
than  the  locally  recommended  regimen,  your  result  would  be  more  promising  and  more  
convincing. Local eradication data and local antibiotics resistance data is very important when it  
comes to H pylori treatment and therefore, you should add more local data in your discussion  
part.
5.Levofloxacin has been recommended and reserved as the 2nd line therapy by many guidelines.  
Could you please share your thoughts on the 2nd line therapy if the patients fail with this CLEB  
regimen. Your point of view will affect feasibility of CLEB regimen is real-world practice.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Yes
Are you able to assess any statistics in the manuscript or would you recommend an additional  
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further  
assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If  
your reply is yes to any, please give details below.
I declare that I have no competing interests
I agree to the open peer review policy of the journal. I understand that my name will be included on my  
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not  
be published.
I agree to the open peer review policy of the journal
assistant