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As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. No prescription was required, and no online consultation was necessary. Further education aimed at patients and the community, as well as increased regulation and application of existing guidelines, can help control this potentially vast reservoir of antibiotics. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. Several studies suggest that antibiotic prescribing for viral illnesses, respiratory tract infections being one example, has declined in the last decade. 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. Our final list of URLs included 184 links to single vendors of antibiotics. Third, we categorized the classes of antibiotics available for purchase. 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. All these obstacles cause the illegal acquisition of antibiotics by patients. This phenomenon has not been the focus of initiatives to control antibiotic resistance. Increased regulation of sites outside of controlled substances to include antibiotics seems guaranteed and necessary. Second, there was a considerable repetition in the Web sites, which made an accurate determination of unique vendors from the 184 different sites difficult, an effort that may have let to some error. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. Recent evidence in ethnic communities in the United States indicates a high level of self-medication with antibiotics either obtained without a prescription in a foreign country and imported into the United States or acquired in the United States without a prescription at stores in ethnic communities.