Bibliometric analysis of pharmacist's research on antimicrobial stewardship in Japan: an interrupted time series analysis on the implementation of the certification system for infection control pharmacists

Abstract

Background: Pharmacist plays an integral role in promoting antimicrobial stewardship (AS) strategies by committing to the evidence-based activities in this field. The present study aims to document trends in actual achievements through bibliometric analysis and identify the future direction of pharmacists with expertise in AS by describing the characteristics of articles on AS written by Japanese pharmacists.

Methods: The study searched for articles written in Japanese and English on Ichushi-Web and MEDLINE, respectively, until December 2020 for published articles relevant to AS. The articles were classified into the seven groups according to content. Interrupted time series analysis (ITSA) was performed to identify the effect of the certification system for infection control pharmacy specialists (ICPSs) on the number of articles in Japanese.

Results: The study retrieved 476 and 145 titles from Ichushi-Web and MEDLINE, respectively, out of which 383 and 123 articles written in Japanese and English, respectively, were considered relevant to AS. A continued publication was found for Japanese articles written by pharmacists assigned to large-sized hospitals since 1998, whereas few articles in English were published until 2017. The most frequent content of articles in both languages was intervention (56.7 and 59.0%, respectively). ITSA indicated that the number of publication slightly increased before [β1 = 1.33, 95% confidence interval (CI): - 0.62-3.28; P = 0.169] the implementation of the system. Moreover, the level (β2 = 11.41, 95%CI: - 0.23-23.05; P = 0.054) increased after the implementation of the system, whereas the slope decreased (β3 = - 2.07, 95%CI: - 4.16-0.03; P = 0.053). However, the changes were not statistically significant.

Conclusion: The study identified the contribution of pharmacists by documenting trends in AS practice and by conducting bibliometric analysis. The implementation of the ICPS certification system positively influenced the trend of publications. Therefore, the study recommends that policymakers and stakeholders should promote and support the evidence-based activities for AS for pharmacists in small- to medium-sized hospitals.

Keywords: Antimicrobial stewardship; Bibliometric analysis; Japan; Pharmacist.

Fig. 1

Flow diagrams of the search and selection of literatue relevant to antimicrobial stewardship. The flow indicates the identification of articles written in a Japanese on Ichushi-Web and b in English on MEDLINE. AS: antimicrobial stewardship

Fig. 2

Annual publications of a Japanese and b English articles in the field of antimicrobial stewardship until 2020. Blue bars indicate pharmacists as first authors; red bars indicates non-pharmacists as first authors

Fig. 3

The line graph indicates a segmented linear regression of pharmacists as first authors of articles written in Japanese during the pre- and post-implementation periods. The trend slightly increased before the implementation period [β1 = 1.33, 95% confidence interval (CI): −0.62–3.28; P = 0.169]. Afterward, the level (β2 = 11.41, 95%CI: − 0.23–23.05; P = 0.054) increased, whereas the slope decreased (β3 = −2.07, 95%CI: −4.16–0.03; P = 0.053)

Fig. 4

The number of annual publications of pharmacists as first authors of Japanese articles divided into seven categories relevant to antimicrobial stewardship. TDM: therapeutic drug monitoring; PBPM: protocol-based pharmacotherapy management