Ivermectin's in vitro activity is real, but so is the gap between lab and real-world application. Think of it like a car that works perfectly in a vacuum—no friction, no weather, no traffic. But when you put it on the road, things change. Ivermectin’s mechanism is promising, but the body isn’t a petri dish. The real-world barriers—like how the drug is absorbed, distributed, and metabolized—can make all the difference. And when those barriers are insurmountable, the theory doesn’t matter. The verdict isn’t just about the science; it’s about what actually works when you’re sick.