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The vendors identified in this study do not appear to be fearful of prosecution. 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. In some cases the URL did not take the reader to an actual medication vendor; rather, the Web site contained multiple advertisements and links to other sites for purchasing antibiotics. 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. Fourth, we have limited our count to English language websites. There are several limitations to this study. 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. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. The frequency of relevant Web sites declined substantially after the first 300. Some prescription medication is sold without a valid prescription, which is a violation of the Federal Food, Drug, and Cosmetic Act. Fifth, we estimated the expected delivery time to take antibiotics. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. European countries struggled with the problem of self-medication with antibiotics and found that the belief in the appropriateness of self-medication with antibiotics for bronchitis and the perceived availability of antibiotics without a prescription was associated with an increased likelihood of self-medication. 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. 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).