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Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. Because of its effect on morbidity and mortality, antibiotic resistance is considered a threat to US health and national security by the Institute of Medicine and the Infectious Diseases Society of America. The medical community and the public health and regulating agencies, as well as pharmaceutical companies, need to expand efforts to control antibiotic resistance beyond initiatives centered on prescribing behavior to include self-medication and sources of antibiotics obtained without prescription. Further education aimed at patients and the community, as well as increased regulation and application of existing guidelines, can help control this potentially vast reservoir of antibiotics. The links to these advertised sites were also investigated. This decrease was interpreted as evidence that the full use of antibiotics was also reduced. We classified Web sites of vendors according to several variables. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. We considered more than 6 pills to be excessive and could lead to future self-medication with the unused pills. 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. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. In usual face-to-face health care visits for respiratory tract infections during which antibiotics are prescribed, more than 90% of prescriptions are filled on the day of the office visit. Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time. This study was not meant to be an exhaustive census of these sites, primarily because with the questionable legality of some of these practices, these sites rapidly come and go.

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