PONE-D-23-26461Outpatient antibiotic prescribing during the first two years of the COVID-19 pandemic: A nationwide register-based time series analysisPLOS ONE

Dear Dr. Kari,

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: General comment:

The is a very interesting paper which has used data to examine the trends in outpatient antibiotic prescribing during the first two years of the COVID-19 pandemic. The has relevant hypothesis, has been performed with solid data and data analysis methods and has been presented well.

Minor comments bellow:

Abstract

Authors state “ Future studies should 16 explore the possible effects of the decline on antimicrobial resistance.” I am wondering of this is more important than understanding reasons for decline here. Steps like a step further than what links more closely with study aim.

Introduction

The authors mention increase and decrease in antibiotic prescription. It would be useful if they discuss what are reasons for such contradicting outcomes in different countries?

Method

The paper has used robust methods for assessment of antibiotic prescribing across different time periods.

Does the study population include all population in Finland that is eligible… based on criteria specified in the manuscript. Or there was some sampling performed. May be useful to clear this.

Results

Presented well

Discussion

Again little discussion on explaining results.

Reviewer #2: In the Introduction section it is presented only azithromycin as a product with an increased consumption.

Question 1. Has authors reviewed consumption of quinolones (Cipro, Levo, Moxi – floxacins) and carbapenems (Imipenem) for an increased consumption as well?

In the lines 45 – 48 are mentioned measures for the pandemics outbreak.

Question 2. Were there also measures (Such as guidelines, orders etc) for antibiotic prescription for or against covid-19 in Finland?

Data, Methods, statistical analysis are presented very well

Discussion to be linked more with conclusion – or conclusion to be expanded more according to the findings.

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Reviewer #1: No

Reviewer #2: No

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Outpatient antibiotic prescribing during the first two years of the COVID-19 pandemic: A nationwide register-based time series analysis

PONE-D-23-26461R1

Dear Dr. Kari,

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,

Arianit Jakupi, PhD

Academic Editor

PLOS ONE

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