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In conclusion, antibiotics are freely available for purchase over the Internet without a prescription, and the general structure of transactions encourages self-medication and poor quality care. Although the vast majority of websites were in English, some were in other languages. We considered more than 6 pills to be excessive and could lead to future self-medication with the unused pills. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. First, this study provides a sample of websites and providers, and thus may not be indicative of all suppliers selling over-the-counter antibiotics. Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time. 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 frequency of relevant Web sites declined substantially after the first 300. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. 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. This phenomenon has not been the focus of initiatives to control antibiotic resistance. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting. 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). Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. 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. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer.