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There are several limitations to this study. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. This activity suggests that some vendors are aware of the questionable legitimacy of their business. Although providing over-the-counter drugs is illegal in the United States, failure to enforce US laws likely encourages these companies to sell their products to patients. In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time. 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. This phenomenon has not been the focus of initiatives to control 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. Thus, vendors targeting foreign-language speakers in the United States would have been missed. Our study is the first to document this phenomenon, and we describe the mechanism for purchasing antibiotics online; future studies will need to document the scope of antibiotics purchased through this mechanism to better understand its direct implications for antibiotic resistance. 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. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. Other providers are trying to upset this law by providing online diagnoses and prescriptions based on medical records without a physical examination and without a long relationship between the patient and the doctor, a practice that is not considered an adequate standard of care. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown.