Global research trends and emerging frontiers of gut microbiota–drug interactions: a bibliometric and visualization analysis (2003–2025)

Abstract

The gut microbiota can alter drug metabolism, efficacy, and toxicity, while medications can reciprocally reshape microbial communities. However, the structure and maturation of research specifically addressing these bidirectional interactions have not been comprehensively mapped. The Web of Science Core Collection (WoSCC) was the sole source for bibliometric mapping because it provides standardized cited-reference metadata. PubMed was used only for complementary search-strategy validation. We analyzed 9,242 English-language articles and reviews published from 2003 through 2025 using VOSviewer, CiteSpace, and bibliometrix. A seeded random sample of 100 WoSCC records was assessed at title/abstract level to evaluate search specificity. The 9,242-publication corpus showed sustained growth, reaching 2,160 publications in 2025. For descriptive comparison, the study period was divided a priori into foundational discovery (2003–2013), translational acceleration (2014–2020), and rapid expansion (2021–2025); these intervals were not statistically estimated change points. Keyword co-occurrence yielded five clusters: pharmacomicrobiomics/drug metabolism, microbiota–immune oncology, metabolic disease, gastrointestinal/inflammatory disorders, and the gut–brain axis. Thematic and burst analyses additionally highlighted natural products, network pharmacology, immunotherapy, and microbiota-directed interventions as recent or rapidly developing topics. In the 100-record specificity audit, 82 records were directly relevant at title/abstract level. This large-scale bibliometric analysis maps the development of gut microbiota–drug interaction research while distinguishing established clusters from topics identified as recent frontiers. The findings support growing translational interest but should not be interpreted as evidence of clinical efficacy or research quality.