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The extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. 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. 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. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. 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. Unfortunately, other disturbing evidence suggests that this problem may not be easily fixed through education, a troubling issue in controlling antibiotic use. 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. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. Moreover, pharmaceutical companies may need to monitor who is selling their products and through what mechanisms. 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. Patients are increasingly using the Internet not only to access health information but also to obtain medication. Finally, in order to determine whether these sites actually provide a product that they intended to sell over the counter, we submitted an online order to 1 vendor for 6 tablets of azithromycin, 500 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. The vendors identified in this study do not appear to be fearful of prosecution. Fourth, we have limited our count to English language websites. The frequency of relevant Web sites declined substantially after the first 300.