Enterprising doctors saved the life of a young cancer patient infected by swine flu by making unlicensed use of Relenza, an antiviral drug, The Lancet reports on Friday.
The 22-year-old patient's immune system had been weakened by Hodgkin's disease and chemotherapy, damaging her defences against the A(H1N1) virus.
She was admitted in July to London's University College Hospital suffering from shortness of breath and fluid buildup in both lungs.
Neither Tamiflu, a pill that is the frontline treatment for swine flu, nor broad-spectrum antibiotics had any effect. By the third day, she was placed on an artificial respirator.
Doctors administered Relenza, also known by its lab name as zanamivir, in its licensed form as a nebulised spray.
But this remedy also failed and over the next two weeks she steadily worsened.
With her life in the balance, the doctors gambled on giving her Relenza intravenously, using a batch specially provided by the drug's manufacturers, GlaxoSmithKline.
They backed this with a high dose of corticosteroids to tackle lung inflammation.
Her condition improved dramatically and within 48 hours she was taken off artificial respiration and transferred out of the hospital's intensive care unit and into a general ward.
The unorthodox treatment had to be approved by the hospital's oversight committee and the patient's next of kin as it is not a recognised strategy for swine flu.
Most of the deaths from swine flu have been related to severe respiratory failure, especially from people with an underlying medical condition.
Physicians Michael Kidd and Mervyn Singer believe their patient's lungs were so impaired by the virus that she could not absorb Relenza in its spray form, so they took a final gamble on an intravenous drip.
Further investigation will confirm whether the treatment can find a wider use beyond a single case report, they said.