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Fifth, we estimated the expected delivery time to take antibiotics. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. 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. In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. This phenomenon has not been the focus of initiatives to control antibiotic resistance. This activity suggests that some vendors are aware of the questionable legitimacy of their business. 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. Our final list of URLs included 184 links to single vendors of antibiotics. Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time. 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. 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. Moreover, pharmaceutical companies may need to monitor who is selling their products and through what mechanisms. Second, we examined whether the vendor would ship prescription antibiotics to a buyer in the United States, as well as several other countries (Canada, United Kingdom) where antibiotics are available only by prescription.

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