A bibliometric analysis and systematic review of drug repurposing against drug-resistant ESKAPE pathogens: a particular focus on Pseudomonas aeruginosa
Abstract
Purpose: Drug-resistant ESKAPE pathogens represent a major global health challenge. This study included a comprehensive bibliometric analysis and systematic review to evaluate drug repurposing efforts against these pathogens, with a particular focus on Pseudomonas aeruginosa.
Methods: We searched the Web of Science Core Collection (2001-April 2025) using the query "ESKAPE AND Drug Resistance AND Drug Repositioning" and performed bibliometric analysis with Bibliometrix (RStudio 4.3.2), VOSviewer 1.6.20, and CiteSpace 6.2R6. In parallel, a systematic review was conducted across PubMed, Embase, Web of Science, and Cochrane Library to identify non-antibiotic agents with reported activity against resistant ESKAPE pathogens.
Results: A total of 443 articles were analyzed bibliometrically, and 141 eligible studies were included in the systematic review, among which 31 focused on drug-resistant P. aeruginosa. The United States, China, and India were the leading contributors, with notable institutional collaborations. Repurposed agents such as niclosamide and mitomycin C exhibited antibacterial activity through mechanisms including membrane permeability disruption, quorum sensing inhibition, and biofilm suppression. Many agents also showed synergistic effects when combined with conventional antibiotics.
Conclusion: By integrating bibliometric mapping with systematic evidence synthesis, this study uniquely highlights both research trends and therapeutic potential in drug repurposing…
How strong is the evidence?
Evidence Hub reads this as a systematic review. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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