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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. Some prescription medication is sold without a valid prescription, which is a violation of the Federal Food, Drug, and Cosmetic Act. First, although all of the included providers would sell antibiotics without a prescription, we assessed whether the supplier would sell antibiotics without any form of prescription or whether a prescription created for the purchase based on the completion of an online medical history was required. 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. Specifically, we classified a single course of azithromycin as 6 pills, 250 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. Our study suggests that the opposite might be the case. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. 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. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. 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. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription.