Reviewer’s report
Title:  Cefuroxime,  levofloxacin,  esomeprazole,  and  bismuth  as  first-line  Helicobacter  pylori  
eradication therapy in patients allergic to penicillin
Version: 3 Date: 24 May 2019
Reviewer: Chao-Hung Kuo
Reviewer's report:
I have raised several suggestions in my previous comments but some of them were not addressed or  
mentioned in your newly revised manuscript. Once again, my suggestions for your revision is the  
following, similar to my previous comments. To make your work more satisfying, these suggestions  
should be addressed or mentioned in the limitation paragraph if the data are not 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.In your table 3, multi-variates analysis should be expressed in your table with p value. It's more  
important than uni-variate analysis.
3.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.
4.You mentioned in your discussion part, that the roughly eradication rates of clarithromycin,  
levofloxacin and metronidazole was 50-60%. The reference should be listed. Reference is very  
important.
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: 3 Date: 24 May 2019
Reviewer: Chao-Hung Kuo
Reviewer's report:
I have raised several suggestions in my previous comments but some of them were not addressed or  
mentioned in your newly revised manuscript. Once again, my suggestions for your revision is the  
following, similar to my previous comments. To make your work more satisfying, these suggestions  
should be addressed or mentioned in the limitation paragraph if the data are not 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.In your table 3, multi-variates analysis should be expressed in your table with p value. It's more  
important than uni-variate analysis.
3.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.
4.You mentioned in your discussion part, that the roughly eradication rates of clarithromycin,  
levofloxacin and metronidazole was 50-60%. The reference should be listed. Reference is very  
important.
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: 3 Date: 24 May 2019
Reviewer: Chao-Hung Kuo
Reviewer's report:
I have raised several suggestions in my previous comments but some of them were not addressed or  
mentioned in your newly revised manuscript. Once again, my suggestions for your revision is the  
following, similar to my previous comments. To make your work more satisfying, these suggestions  
should be addressed or mentioned in the limitation paragraph if the data are not 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.In your table 3, multi-variates analysis should be expressed in your table with p value. It's more  
important than uni-variate analysis.
3.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.
4.You mentioned in your discussion part, that the roughly eradication rates of clarithromycin,  
levofloxacin and metronidazole was 50-60%. The reference should be listed. Reference is very  
important.
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