PONE-D-22-28098Impact of the COVID-19 pandemic and multiplex polymerase chain reaction test on outpatient antibiotic prescriptions for pediatric respiratory infectionPLOS ONE

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Reviewer #1: Yes

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Reviewer #1: Yes

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Reviewer #1: Yes

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Reviewer #1: Yes

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Reviewer #1: This manuscript makes clever use of interrupted time series analysis to analyze the impact of the COVID-19 pandemic and the FilmArray Respiratory Panel on antibiotic prescriptions of the outpatient with pediatric respiratory infections.

Although two time points of the events and their response strategy have no significant correlation with the sustained reduction of antibiotic prescription rate, it still suggests that drug resistance monitoring is as important as epidemic monitoring, and standard guidelines for clinicians' prescribing behavior are more important.

I was very glad to read the interesting findings observed from author’s clinical perspective, The following questions are purely out of personal curiosity and do not affect the logic of the full text.

1. Compared with the pre pandemic period, age rate of patients less than 3 months is declining in pandemic period shown in Table 1. However, antibiotics prescribed rate of cephalosporins increases from 8.5 to 9.3 in Supplementary Table S1. Is this increase statistically significant? If so, why does this phenomenon occur in the youngest infants?

2. The RAT period has crossed pre- and pandemic period, however, the multiplex PCR period only covers pandemic period. Whether the data in the post-pandemic period still support the observation results in this paper is very promising.

In addition, there are some specific details that may need to be modified.

3. Only one P value (=0.33) has two decimal places reserved in Table 2, the others are all three. However, from abstract to text, most P values tend to be two digits on Line 37, 38, 180, 181, 193, 195, 197, and 200 etc., and three on Line 190. Although understanding the author may be due to the simple habit, it could keep consistent with the full manuscript including tables to avoid unnecessary conversion, comparison and misunderstanding for readers.

4. Line 261 to 264 was more suitable for discussion than conclusion. After all, there is no data on hospitalized children in this article, and no comparison to support this conclusion.

5. The interrupted time series analysis appears on Line 177, but its abbreviation ITSA first appeared on Line 87.

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Reviewer #1: No

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Impact of the COVID-19 pandemic and multiplex polymerase chain reaction test on outpatient antibiotic prescriptions for pediatric respiratory infection

PONE-D-22-28098R1

Dear Dr. Kitagawa,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Benjamin M. Liu, MBBS, PhD, D(ABMM), MB(ASCP)

Academic Editor

PLOS ONE

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