Reviewer's report
Title:Antibiotic exposure and the development of coeliac disease: A nationwide
case-control study
Version: 1Date:30 May 2013
Reviewer: Geoffrey Holmes
Reviewer's report:
The authors made the hypothesis that there is a positive association between the
consumption of antibiotics and coeliac disease and used impressive data bases
held in Sweden to test this. A positive association was found and this could
indicate that antibiotics by affecting the intestinal microflora play a part in the
causation of coeliac disease. Alternatively, antibiotics may be given for
symptoms of as yet undiagnosed coeliac disease and so play no part in the
pathogenesis.
The researchers designed this investigation to try and overcome this last
scenario by studying not only those with coeliac disease but those with intestinal
inflammation and potential coeliac disease and the relationship held in all these
groups. It was stronger with repeated use of antibiotics and for all antibiotics
studied other than penicillin V. However, that antibiotics play a causal role in
coeliac disease can never be fully proved. The authors recognise this and fully
discuss the limitations and strengths of their study.
Comments
Minor Essential Revisions
The sections of this paper are out of order. The Methods section comes after the
Discussion and Comments and the references follow this pattern. This must be
an error of presentation and requires correction.
Abstract. Satisfactory and states quite clearly that a non-causal explanation for
the positive association cannot be excluded,
Background, Methods and Results. Well presented.
Discussion. Deals well with the issues raised in the study.
Reference list. Relevent.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Antibiotic exposure and the development of coeliac disease: A nationwide
case-control study
Version: 1Date:30 May 2013
Reviewer: Geoffrey Holmes
Reviewer's report:
The authors made the hypothesis that there is a positive association between the
consumption of antibiotics and coeliac disease and used impressive data bases
held in Sweden to test this. A positive association was found and this could
indicate that antibiotics by affecting the intestinal microflora play a part in the
causation of coeliac disease. Alternatively, antibiotics may be given for
symptoms of as yet undiagnosed coeliac disease and so play no part in the
pathogenesis.
The researchers designed this investigation to try and overcome this last
scenario by studying not only those with coeliac disease but those with intestinal
inflammation and potential coeliac disease and the relationship held in all these
groups. It was stronger with repeated use of antibiotics and for all antibiotics
studied other than penicillin V. However, that antibiotics play a causal role in
coeliac disease can never be fully proved. The authors recognise this and fully
discuss the limitations and strengths of their study.
Comments
Minor Essential Revisions
The sections of this paper are out of order. The Methods section comes after the
Discussion and Comments and the references follow this pattern. This must be
an error of presentation and requires correction.
Abstract. Satisfactory and states quite clearly that a non-causal explanation for
the positive association cannot be excluded,
Background, Methods and Results. Well presented.
Discussion. Deals well with the issues raised in the study.
Reference list. Relevent.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Antibiotic exposure and the development of coeliac disease: A nationwide
case-control study
Version: 1Date:30 May 2013
Reviewer: Geoffrey Holmes
Reviewer's report:
The authors made the hypothesis that there is a positive association between the
consumption of antibiotics and coeliac disease and used impressive data bases
held in Sweden to test this. A positive association was found and this could
indicate that antibiotics by affecting the intestinal microflora play a part in the
causation of coeliac disease. Alternatively, antibiotics may be given for
symptoms of as yet undiagnosed coeliac disease and so play no part in the
pathogenesis.
The researchers designed this investigation to try and overcome this last
scenario by studying not only those with coeliac disease but those with intestinal
inflammation and potential coeliac disease and the relationship held in all these
groups. It was stronger with repeated use of antibiotics and for all antibiotics
studied other than penicillin V. However, that antibiotics play a causal role in
coeliac disease can never be fully proved. The authors recognise this and fully
discuss the limitations and strengths of their study.
Comments
Minor Essential Revisions
The sections of this paper are out of order. The Methods section comes after the
Discussion and Comments and the references follow this pattern. This must be
an error of presentation and requires correction.
Abstract. Satisfactory and states quite clearly that a non-causal explanation for
the positive association cannot be excluded,
Background, Methods and Results. Well presented.
Discussion. Deals well with the issues raised in the study.
Reference list. Relevent.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
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