Clioquinol
| Evidence Level: L3 | Predicted Indications: 7 |
Table of Contents
Clioquinol: From Topical Antifungal/Antibacterial Use to Cutaneous Candidiasis
One-Sentence Summary
Clioquinol (iodochlorhydroxyquin) is a halogenated hydroxyquinoline long formulated into topical corticosteroid-antimicrobial combination creams (e.g., Vioform-hydrocortisone, Locacorten-Vioform), though it currently holds no market registration in this system and no detailed mechanism-of-action record is on file. The TxGNN model predicts it may be effective for cutaneous candidiasis, and — unusually for a pure model prediction — this direction is already backed by 6 historical clinical publications describing clioquinol-containing creams used against candidal skin infections, even though no modern clinical trials have been registered. This gives the prediction an evidence level of L3, reflecting observational/comparative clinical use rather than either a purely computational guess or a modern RCT-confirmed indication.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not on file — drug is unregistered locally, no approved indication text available (see Market Information below) |
| Predicted New Indication | Cutaneous Candidiasis |
| TxGNN Prediction Score | 99.84% |
| Evidence Level | L3 |
| India Market Status | Not Marketed |
| Number of Registrations | 0 |
| Recommended Decision | Proceed with Guardrails |
Why is This Prediction Reasonable?
Currently, detailed mechanism-of-action data for clioquinol is not available in this evidence pack (data gap DG002, High severity). Based on general pharmacological knowledge, clioquinol is a halogenated 8-hydroxyquinoline derivative that has long been formulated into topical corticosteroid–antimicrobial combination products (e.g., Vioform-hydrocortisone, Locacorten-Vioform, halcinonide-Vioform). Its antifungal activity is generally attributed to metal chelation that disrupts the cell membrane and enzymatic systems of Candida albicans and related fungi.
Clioquinol’s own historical clinical use is concentrated in dermatological infections — including cutaneous candidiasis, the very indication TxGNN is now predicting. Several older comparative studies captured in this evidence pack (PMID 155507, 6459255, 128475) directly evaluated clioquinol-containing creams against cutaneous candidiasis and secondarily infected dermatoses, with one reporting a 95% overall therapeutic response rate. This makes the TxGNN output less a novel discovery than a model-driven re-confirmation of a use pattern with decades of documented clinical precedent — though contemporary randomized controlled trial data is absent.
Mechanistically, cutaneous candidiasis is a superficial yeast infection of the skin, squarely within the antimicrobial spectrum long attributed to iodochlorhydroxyquin-based products. This gives the TxGNN-predicted association strong biological plausibility, even in the absence of a documented formal MOA record.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 155507 | 1979 | Cohort/Clinical Evaluation | Current Medical Research and Opinion | Halcinonide-neomycin-amphotericin cream vs. iodochlorhydroxyquin-hydrocortisone in cutaneous candidiasis: 95% (38/40) vs. 43% (17/40) overall therapeutic response |
| 6459255 | 1981 | Cohort/Clinical Evaluation | The Journal of International Medical Research | Randomized comparison (n=154) of two topical corticosteroid-antimicrobial creams, one containing iodochlorhydroxyquin, showed equivalent therapeutic responses in cutaneous candidiasis and infected eczematous dermatoses |
| 128475 | 1975 | Cohort/Clinical Evaluation | Dermatologica | Double-blind study (n=430): Locacorten-Vioform (clioquinol) cream markedly more effective than either agent alone or placebo against secondarily infected dermatoses |
| 136333 | 1976 | Cohort/Clinical Evaluation | Current Therapeutic Research, Clinical and Experimental | Clinical evaluation of a new halcinonide-antifungal (clioquinol) combination cream (abstract not available) |
| 4220930 | 1965 | Case Report/Etiology Study | Zeitschrift für Haut- und Geschlechtskrankheiten | Discussion of yeast (Candida) involvement in the etiology of Danbolt-Closs acrodermatitis enteropathica |
| 2978600 | 1988 | Review/Prevention Study | Przegląd Dermatologiczny | In vitro evaluation of antimicrobial soap additives with fungicidal activity against Candida albicans, aimed at preventing occupational infection |
India Market Information
Clioquinol currently has no market authorization or registration on file (market status: Not Marketed; total licenses: 0).
Safety Considerations
Please refer to the package insert for safety information.
Conclusion and Next Steps
Decision: Proceed with Guardrails
Rationale: Multiple historical cohort/comparative studies (evidence level L3) directly support clioquinol’s antifungal efficacy in cutaneous candidiasis-type infections, and the mechanistic plausibility is strong given its well-established antimicrobial spectrum. However, the absence of modern RCT data, no current local market authorization, and a Blocking data gap on regulatory safety warnings (DG001) mean this cannot yet advance past a guarded, staged evaluation.
To proceed, the following is needed:
- Local label warnings and contraindications data (DG001, Blocking) — required before Stage 1 safety screening can be completed
- Documented mechanism-of-action data from DrugBank (DG002, High) to formally support the mechanistic rationale
- A completed drug interaction (DDI) database query (current status: not found)
- Separate evaluation of the other TxGNN-predicted indications for this drug (Majocchi granuloma, ectothrix/endothrix infectious disease, superficial mycosis, scalp/beard dermatophytosis, tinea profunda) — all score above 99% but remain at evidence level L5 (model prediction only, Research Question stage) and should not be prioritized ahead of cutaneous candidiasis
- Updated local market/registration status assessment if local registration is being considered
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.