A judge in the US state of Ohio has said a hospital cannot be forced to administer an unproven treatment to a patient with Covid-19, reversing the ruling of another court.
Judge Gregory Howard had ordered West Chester Hospital to administer the antiparasitic drug ivermectin to Jeff Smith, as prescribed by his physician, for 14 days.
Smith's wife, Julie, had filed suit to force the hospital located outside Cincinnati to begin giving ivermectin to her 51-year-old husband, who has been on a ventilator since August 1.
Judge Michael Oster reversed Howard's order on Monday.
While "everyone involved wants Jeff Smith to get better," Oster said, the medical community at large does not advocate the use of ivermectin to treat Covid-19.
"No strong evidence by way of study or data analysis can, at this time, show that ivermectin should be recommended for Covid-19 treatment," Oster said. "Based on the current evidence, ivermectin is not effective as a treatment for Covid-19."
UC Health, which runs the West Chester Hospital, welcomed the judge's ruling.
"We respect the expertise of our clinicians and appreciate the scientific rigor used to develop treatments, medications and other therapies," UC Health said.
"We do not believe that hospitals or clinicians should be ordered to administer medications and/or therapies, especially unproven medications and/or therapies, against medical advice."
The case is one of several nationwide where courts have sided with litigants seeking to use ivermectin, despite scant evidence of its effectiveness against Covid and a rise in calls to poison centers as a result of misuse.
Since the start of the Covid pandemic, there has been considerable interest in repurposing existing medications.
Ivermectin attracted much attention, particularly in Latin America, and early lab studies suggested it might have beneficial properties for fighting the coronavirus.
But, as is often the case, promise in lab settings has so far failed to translate to real world success, as judged by its lack of clear efficacy in trials.
The National Institutes of Health says there is not enough evidence "either for or against the use of ivermectin for the treatment of Covid-19" until clear results become available from rigorous trials.
Ivermectin is approved by the Food and Drug Administration to treat people with certain conditions caused by parasitic worms, but the agency has warned people against using it for Covid.
A report by the Centers for Disease Control and Prevention showed that by mid-August, physicians were writing out more than 88,000 prescriptions of the drug per week -- well above the pre-pandemic baseline of 3,600.
Poison control centers have seen a three-fold increase in the number of calls for ivermectin overdoses.
Ivermectin's popularity against Covid has drawn comparisons to hydroxychloroquine, an anti-malarial drug that was particularly favored by conservatives last year, despite no strong evidence of real world efficacy.