Antimicrobial Resistance: A Bibliometric Review of Patient Health, Mechanisms, and Therapeutic Strategies

Antimicrobial resistance is a growing global health crisis, with projections estimating up to 10 million deaths annually and more than 130 million hospitalizations attributable to resistant infections. Resistance emerges through microbial adaptation to sustained antimicrobial pressure, resulting in genetic and phenotypic mechanisms such as target mutations, enzymatic drug inactivation, efflux pump activation, biofilm formation, and metabolic adaptation that drive the emergence of multidrug-resistant pathogens and limit effective therapy. This bibliometric review analyzes the MEDLINE-indexed articles to characterize patient health and age factors, resistance mechanisms, pathogen types, and therapeutic strategies associated with antimicrobial resistance. The findings demonstrate that antimicrobial resistance is disproportionately reported among adults and chemotherapy-treated patients, with transmitted resistance emerging as the dominant driver, emerging from antibiotic misuse or overuse. Despite extensive mechanistic knowledge, treatment remains largely focused on escalation to newer antibiotics, while combination and adjunctive therapies are less commonly reported. These results analyze 308,290 studies to identify patient-related contexts, resistance mechanisms, pathogens, and therapeutic strategies.