Trends in antimicrobial resistance education research: a bibliometric analysis

Abstract

Background: Antimicrobial resistance (AMR) poses a severe public health threat, with educational interventions recognized as pivotal in mitigating its impact. The World Health Organization (WHO) Global Action Plan on AMR emphasizes awareness and education as fundamental strategies. Given the complex interplay between human, animal, and environmental health in the development and spread of AMR, educational initiatives are increasingly being framed within a One Health approach. This study aims to examine the scientific production on AMR education of healthcare professionals and the general population.

Methods: A bibliometric analysis was performed on AMR education literature on the Web of Science Core Collection database up to December 2023. Using the Biblioshiny tool within the Bibliometrix R package, the analysis covered productivity metrics, citation impact, keyword co-occurrence, and thematic mapping.

Results: The study analyzed 1124 documents published on AMR education between 1995 and 2023, with a 20.5 % annual growth in publications. Key journals included Antibiotics-Basel and PLOS ONE, while highly cited sources were Journal of Antimicrobial Chemotherapy and Clinical Infectious Diseases. The University of London and the US led in institutional and country contributions. Keywords like "knowledge", "attitudes", and "stewardship" were central, reflecting the focus on educational initiatives. Thematic evolution revealed significant growth, with the number of themes increasing from four in 1995-2008 to 20 by 2021-2023, demonstrating the dynamic and expanding nature of research in this field.

Conclusions: The expansion of AMR education research reflects growing global commitment to combating AMR through targeted educational strategies. Framing AMR education within the One Health approach may enhance its effectiveness, by addressing the interconnected drivers of resistance across sectors. Our findings highlight the importance of sustaining international collaboration and aligning AMR educational efforts with national policies. Future research should emphasize interdisciplinary approaches and innovative methods to address the complex challenges of AMR across diverse populations.

Keywords: Antimicrobial resistance; Awareness; Education; Research.

Fig. 1

Annual scientific production on AMR education. Trend in the number of publications on AMR education from 1995 to 2023. The figure shows a substantial increase in scientific output over time, particularly after 2010, with a peak of 185 articles in 2023. This trend reflects the growing global attention to AMR and the increasing prioritization of educational strategies as part of mitigation efforts.

Fig. 2

Distribution of scientific production (number of publications) on AMR education across countries worldwide. World map showing the number of publications on AMR education by country. Darker shades indicate higher publication volumes. The United States, the United Kingdom, and Australia emerged as the top contributing countries, reflecting their strong engagement in AMR education research and policy development.

Fig. 3

Corresponding author's countries and collaborations. Bar chart illustrating the top contributing countries based on the affiliation of corresponding authors. The chart distinguishes between single country publications (SCP) and multiple country publications (MCP), reflecting the extent of international collaboration. The United Kingdom showed the highest proportion of MCP (45 %), followed by Australia (33 %) and the United States (14 %), highlighting differing patterns of international research engagement.

Fig. 4

Collaboration network World map. World map showing the international collaboration network in AMR education research. Lines represent co-authorship links between countries, and only connections between countries that have collaborated more than twice are shown. Strong collaboration patterns are observed particularly in Europe and North America, highlighting the role of cross-national partnerships in advancing AMR education.

Fig. 5

Thematic map of scientific production on AMR education. Thematic map based on keyword co-occurrence analysis, plotting clusters according to their centrality (relevance) and density (development). “Staphylococcus aureus” and “animals” appear as motor themes, indicating high relevance and strong development. “knowledge” and “stewardship” are identified as basic themes, essential to the field but less internally developed. Niche and emerging or declining themes are also represented, reflecting the diversity and evolution of research topics in AMR education.

Fig. 6

Thematic evolution of scientific production on AMR education. Sankey diagram showing the evolution of major research themes on AMR education across three time periods: 1995–2008, 2009–2020, and 2021–2023. Themes such as “Staphylococcus aureus”, “knowledge”, and “stewardship” show continuity and expansion over time, while new topics like “respiratory-tract infections”, “barriers”, and “implementation” emerged more recently. The increasing number and complexity of themes illustrate the diversification and maturation of the research field.