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Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time. This activity suggests that some vendors are aware of the questionable legitimacy of their business. The frequency of relevant Web sites declined substantially after the first 300. This practice also occurs in the United States even though the United States regulates the acquisition of antibiotics, which will be limited by prescription only. Increased regulation of sites outside of controlled substances to include antibiotics seems guaranteed and necessary. 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. In addition, the available quantities and the interval between prescribing and receiving treatment suggest that these transactions will likely be used by people storing drugs for future self-diagnosis and treatment, or for sale. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. 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. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. 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. Our purchase arrived from Mexico with no information on instructions for use of the medication. Fourth, we have limited our count to English language websites. 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. Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations.