Reviewer ’s report  
 
Title: Amoxicillin/Clavulanic Acid -Induced Pancreatitis: Case Report  
 
Version: 1 Date: 19 Apr 2018  
 
Reviewer: Rakesh Aggarwal  
 
Reviewer's report:  
 
This manuscript describes a patient with acute pancreatitis in whom no discernible cause was 
found, and there was history of amoxycillin -clavulanate intake a few days ago. Though it is 
possible that the pancreatitis was related to this drug, it is difficult to be reasonably certain of this 
association based on the det ails provided.  
It appears that the original submission was reviewed by another reviewer who raised several 
valid questions. Though the authors have tried to answer those questions, the responses to not 
add to the certainty of the association between the drug and the illness. One needs to bear in 
mind that a large proportion of acute pancreatitis cases are idiopathic, and that may be applicable 
here too.  
The criteria for testing for genetic causes that the authors refer to are for general clinical use, a nd 
do not necessarily apply in this case, where a specific drug -induced cause is being considered.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
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.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing inter ests, 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 c ontent 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 att achments 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: Amoxicillin/Clavulanic Acid -Induced Pancreatitis: Case Report  
 
Version: 1 Date: 19 Apr 2018  
 
Reviewer: Rakesh Aggarwal  
 
Reviewer's report:  
 
This manuscript describes a patient with acute pancreatitis in whom no discernible cause was 
found, and there was history of amoxycillin -clavulanate intake a few days ago. Though it is 
possible that the pancreatitis was related to this drug, it is difficult to be reasonably certain of this 
association based on the det ails provided.  
It appears that the original submission was reviewed by another reviewer who raised several 
valid questions. Though the authors have tried to answer those questions, the responses to not 
add to the certainty of the association between the drug and the illness. One needs to bear in 
mind that a large proportion of acute pancreatitis cases are idiopathic, and that may be applicable 
here too.  
The criteria for testing for genetic causes that the authors refer to are for general clinical use, a nd 
do not necessarily apply in this case, where a specific drug -induced cause is being considered.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
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.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing inter ests, 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 c ontent 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 att achments 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: Amoxicillin/Clavulanic Acid -Induced Pancreatitis: Case Report  
 
Version: 1 Date: 19 Apr 2018  
 
Reviewer: Rakesh Aggarwal  
 
Reviewer's report:  
 
This manuscript describes a patient with acute pancreatitis in whom no discernible cause was 
found, and there was history of amoxycillin -clavulanate intake a few days ago. Though it is 
possible that the pancreatitis was related to this drug, it is difficult to be reasonably certain of this 
association based on the det ails provided.  
It appears that the original submission was reviewed by another reviewer who raised several 
valid questions. Though the authors have tried to answer those questions, the responses to not 
add to the certainty of the association between the drug and the illness. One needs to bear in 
mind that a large proportion of acute pancreatitis cases are idiopathic, and that may be applicable 
here too.  
The criteria for testing for genetic causes that the authors refer to are for general clinical use, a nd 
do not necessarily apply in this case, where a specific drug -induced cause is being considered.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
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.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing inter ests, 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 c ontent 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 att achments 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