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This activity suggests that some vendors are aware of the questionable legitimacy of their business. In usual face-to-face health care visits for respiratory tract infections during which antibiotics are prescribed, more than 90% of prescriptions are filled on the day of the office visit. This reservoir of antibiotics is likely to be used inappropriately-the Web sites promote self-diagnosis and self-medication, and antibiotics are likely to be used in inappropriate dosages. 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. Self-administration of antibiotics occurs in all countries, but it is particularly problematic where the use of antimicrobials without a prescription is encouraged by the lack of laws restricting antibiotic sales or a failure to enforce the laws. 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 decrease was interpreted as evidence that the full use of antibiotics was also reduced. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations. Our study suggests that the opposite might be the case. No prescription was required, and no online consultation was necessary. In conclusion, antibiotics are freely available for purchase over the Internet without a prescription, and the general structure of transactions encourages self-medication and poor quality care. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. Although the vast majority of websites were in English, some were in other languages. 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.