Global randomised controlled trials in infection prevention and control: a bibliographic review from the past two decades

Abstract

Infection prevention and control (IPC) evidence is imperative to reduce healthcare-associated infections, yet IPC guidelines often rely on low-level evidence due to challenges in conducting rigorous randomised controlled trials (RCTs). Understanding long-term research trends can clarify strengths, gaps, and priorities. Therefore, this bibliometric review aimed to identify trends and patterns in IPC RCTs over the past 20 years. A systematic search was conducted in the Scopus database between January 2002 and September 2025. RCTs in IPC were included. Identified studies were exported into Covidence software for screening. Metadata were imported into Biblioshiny® software, which analysed annual scientific production, citation data, authorship, and collaboration. Manual coding of data was also conducted to assign themes to the included research. This bibliometric review was reported in accordance with the BIBLIO reporting checklist. The search yielded 2312 studies, of which 239 were included. The findings show intermittent periods of growth in annual publication output, particularly in the past two years. Research activity is concentrated in the USA, Australia, and the UK. Over half of all publications fall within four key IPC themes - medical devices, skin antisepsis, wound therapy, and hand hygiene - while remaining studies reflect considerable topic heterogeneity. RCTs in IPC has grown substantially over the past decade. Although existing international collaborations were identified, substantial scope remains to further strengthen these networks. This presents an opportunity to strengthen the evidence base. Given the growth of RCTs, there is a case for living guidelines in key IPC areas.