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If patients who are now denied antibiotics through their physician can access over-the-counter medications, the overall level of antibiotic use in the general population can actually increase and thus have a significant effect on rates of resistance to microbial degradation. Although more than half of the identified sites provided online consultation for prescribing, the lack of interaction between the patient and the doctor did not lead to any opportunity for patient education. In addition, the ability of Internet-based companies to exist without an identifiable physical location or property makes the location and writing of FDA instructions extremely difficult. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. If those who are self-medicating are taught that they put their own health at risk, they may be less likely to use these online pharmacies. Although excessive consumption of antibiotics has contributed to the spread of antibiotic resistance, 4-6 most initiatives regarding inappropriate direct human consumption of the antibiotic therapy center are almost exclusively controlled by prescribing by healthcare clinicians. Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations. Fourth, we categorized whether a person could buy antibiotics, especially broad-spectrum antibiotics, in quantities greater than what would be considered adequate 1 course of treatment for acute respiratory tract infection. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. Fifth, we estimated the expected delivery time to take antibiotics. Fourth, we have limited our count to English language websites. 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 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. The findings described in this study suggest that there is a potentially large pool of antibiotics in the United States that is not affected by initiatives to change physician-prescribing practices and may be contributing to antibiotic resistance. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site.