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After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. 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. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. Thus, vendors targeting foreign-language speakers in the United States would have been missed. The medical community and the public health and regulating agencies, as well as pharmaceutical companies, need to expand efforts to control antibiotic resistance beyond initiatives centered on prescribing behavior to include self-medication and sources of antibiotics obtained without prescription. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. No prescription was required, and no online consultation was necessary. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. 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 some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting. 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. 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. We classified Web sites of vendors according to several variables.