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Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations. Clinicians evaluating the patient's use of self-medication when taking a medical history may function as an important opportunity to tell patients about not only antibiotic resistance, but also potential interactions between antibiotics and other prescription drugs. Thus, vendors targeting foreign-language speakers in the United States would have been missed. Our final list of URLs included 184 links to single vendors of antibiotics. Fourth, we have limited our count to English language websites. 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. Most initiatives, however, focus almost exclusively on controlling prescribing by health care clinicians and do not focus on patient self-medication. Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time. We classified Web sites of vendors according to several variables. We assessed whether individuals could purchase penicillins, macrolides, fluoroquinolones, and cephalosporins, because the availability of multiple classes of antibiotics would affect additional selective pressure in the community. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. 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. Third, we categorized the classes of antibiotics available for purchase. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. 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.

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