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We considered more than 6 pills to be excessive and could lead to future self-medication with the unused pills. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet. 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. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. Recent evidence in ethnic communities in the United States indicates a high level of self-medication with antibiotics either obtained without a prescription in a foreign country and imported into the United States or acquired in the United States without a prescription at stores in ethnic communities. No prescription was required, and no online consultation was necessary. As part of this study, we bought over-the-counter antibiotics over the counter. 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. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. For example, we found that servers at Dartmouth College, East Carolina University, University of Pittsburgh, Carnegie Mellon University, and California State University in San Francisco were all used, most likely without their knowledge, to be reassigned to online pharmacies. This phenomenon has not been the focus of initiatives to control antibiotic resistance. 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. 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. Thus, as soon as patients receive over-the-counter antibiotics and self-treating self-limiting illnesses with drugs, such as upper-respiratory tract infections without complications, they are likely to suggest that the antibiotic was effective, and self-medicate in the future. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives.