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The links to these advertised sites were also investigated. In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. Some prescription medication is sold without a valid prescription, which is a violation of the Federal Food, Drug, and Cosmetic Act. Thus, vendors targeting foreign-language speakers in the United States would have been missed. 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. 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. 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. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. Patients are increasingly using the Internet not only to access health information but also to obtain medication. 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. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. 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. The vendors identified in this study do not appear to be fearful of prosecution. This activity suggests that some vendors are aware of the questionable legitimacy of their business.

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