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Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations. This study was not meant to be an exhaustive census of these sites, primarily because with the questionable legality of some of these practices, these sites rapidly come and go. This activity suggests that some vendors are aware of the questionable legitimacy of their business. If those who are self-medicating are taught that they put their own health at risk, they may be less likely to use these online pharmacies. 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. 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. Some prescription medication is sold without a valid prescription, which is a violation of the Federal Food, Drug, and Cosmetic Act. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer. This phenomenon has not been the focus of initiatives to control antibiotic resistance. The links to these advertised sites were also investigated. Fourth, we categorized whether a person could buy antibiotics, especially broad-spectrum antibiotics, in quantities greater than what would be considered adequate 1 course of treatment for acute respiratory tract infection. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. 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. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each.

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