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Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. Second, there was a considerable repetition in the Web sites, which made an accurate determination of unique vendors from the 184 different sites difficult, an effort that may have let to some error. In addition, the available quantities and the interval between prescribing and receiving treatment suggest that these transactions will likely be used by people storing drugs for future self-diagnosis and treatment, or for sale. Third, we categorized the classes of antibiotics available for purchase. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. Second, we examined whether the vendor would ship prescription antibiotics to a buyer in the United States, as well as several other countries (Canada, United Kingdom) where antibiotics are available only by prescription. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. The frequency of relevant Web sites declined substantially after the first 300. The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. First, although all of the included providers would sell antibiotics without a prescription, we assessed whether the supplier would sell antibiotics without any form of prescription or whether a prescription created for the purchase based on the completion of an online medical history was required. To examine the types of Web sites and vendors dispensing antibiotics on the Internet, we conducted a search using 2 major search engines (Google and Yahoo) and the key words "purchase antibiotics without prescription" and "online (English only). This practice also occurs in the United States even though the United States regulates the acquisition of antibiotics, which will be limited by prescription only. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. We assessed whether individuals could purchase penicillins, macrolides, fluoroquinolones, and cephalosporins, because the availability of multiple classes of antibiotics would affect additional selective pressure in the community. We considered more than 6 pills to be excessive and could lead to future self-medication with the unused pills.