Systematic review maps 50 most-cited articles on pediatric respiratory infections

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medRxiv Published May 22, 2026 Medically reviewed May 22, 2026 Study authors: Albakri, S. A.; Almasoudi, G. S.; Albakri, D. A.; Aljariry, J. F.; Aljohny, L. B.; Rizg, L. N.; Alza… DOI ↗ By Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

Key Takeaway

Recognize that the top-cited literature on pediatric respiratory infections is dominated by observational studies from high-income countries, limiting causal inference.

This systematic bibliometric review identified and analyzed the 50 most-cited articles on pediatric respiratory infections, spanning publication years 1978 to 2021 with over half published in the 2010s. Citation counts ranged from 34 to 384, with a right-skewed distribution. Leading contributing countries were the United States (18%), China (12%), and Canada (10%).

Regarding study design, cohort studies comprised 66% of the articles, randomized trials 12%, and reviews or meta-analyses 16%. The main research themes included clinical outcomes such as pneumonia and bronchiolitis, viral etiology and diagnostics (notably RSV and SARS-CoV-2), and antimicrobial stewardship.

The authors note important limitations: the evidence base relies heavily on observational studies from high-income countries, with limited representation from randomized trials, systematic reviews, multicenter collaborations, and low- and middle-income country (LMIC)-led research. This restricts the generalizability and strength of conclusions.

For clinicians, this review highlights the need for more high-quality interventional research and global collaboration to strengthen the evidence base for pediatric respiratory infection management. The current literature provides a foundation but is skewed toward observational data from a few countries.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

Abstract Background: Pediatric respiratory infections are a leading cause of morbidity and mortality globally, representing a major health challenge in children. Research Gap: Despite extensive studies on epidemiology, clinical management, and specific pathogens, no bibliometric analysis has systematically evaluated the most influential research in this field. Objectives: This study aimed to evaluate the characteristics of the top 50 most-cited articles on pediatric respiratory infections and to identify emerging research trends. Methods: The Web of Science database was searched without publication year restrictions. Independent reviewers screened studies based on predefined inclusion and exclusion criteria. Data were extracted using a standardized form, including study details. Results: The 50 most-cited articles ranged from 34 to 384 citations and showed a right-skewed distribution with a sharp drop after the top ten. Publication years ranged from 1978 to 2021, with over half published in the 2010s. Articles appeared in 31 journals, with Pediatrics contributing five. Leading countries were the United States (18%), China (12%), and Canada (10%), with research largely concentrated in high-income regions and limited multicenter collaboration. Cohort studies dominated (66%), while randomized trials (12%) and reviews/meta-analyses (16%) were less common. Research clustered around three themes: clinical outcomes (e.g., pneumonia, bronchiolitis); viral etiology/diagnostics (e.g., RSV, SARS-CoV-2); and antimicrobial stewardship. Conclusion: Over the past decades, pediatric respiratory infection research has developed but remains unbalanced, relying heavily on observational evidence from high-income countries, with limited randomized trials, systematic reviews, multicenter collaborations, and LMIC-led studies. These findings provide insights that may direct researchers to identify potential focal points and guide future research in the field.