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That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. We classified Web sites of vendors according to several variables. 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. 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. The extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. Fifth, we estimated the expected delivery time to take antibiotics. Finally, and potentially the biggest limitation on the importance of this study, is that we were unable to describe how this Internet-based purchasing strategy was used to purchase people with antibiotics in the United States. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. Third, we categorized the classes of antibiotics available for purchase. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. This activity suggests that some vendors are aware of the questionable legitimacy of their business. In some cases the URL did not take the reader to an actual medication vendor; rather, the Web site contained multiple advertisements and links to other sites for purchasing antibiotics. In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer. Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time.