Global trends and thematic evolution in antimicrobial stewardship research: a comprehensive bibliometric and network...

Antimicrobial stewardship (AMS) is a vital strategy in addressing antimicrobial resistance globally. However, no prior bibliometric study has comprehensively assessed the global evolution, intellectual structure, and thematic development of AMS research across an extended timeframe. This study presents a comprehensive bibliometric analysis to map the evolution, productivity, and collaboration patterns in AMS research from 1977 to 2025.

A total of 9321 original articles were retrieved from the Scopus database. A bibliometric analysis was conducted using Bibliometrix (R-package) and VOSviewer, with a focus on publication trends, citation patterns, Lotka's and Bradford's laws, co-authorship networks, thematic evolution, and keyword co-occurrence.

From 1977 to 2025, AMS research experienced sustained growth, particularly after 2010, reaching a peak of 1246 publications in 2024. The USA led in scientific output (3286 articles) and citations (73,569), followed by the UK (1291 articles; 28,668 citations). Among individual researchers, Hersh AL authored 57 papers (3558 citations), and Gerber JS contributed 52 papers (3216 citations), indicating their central influence. Although citation counts declined in recent years due to limited time for accumulation, collaboration and thematic diversity notably increased. Recent research incorporated artificial intelligence, molecular characterization, and public health. Bradford's law identified core journals such as Antibiotics and Journal of Antimicrobial Chemotherapy, while Lotka's law confirmed the dominance of a small group of highly productive authors.

This analysis highlights a global expansion in AMS research, with increasing collaboration and thematic diversification. These findings support evidence-based policymaking, research prioritization, and innovation in stewardship strategies.