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That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. 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. In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. 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. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. Our study suggests that the opposite might be the case. Thus, as soon as patients receive over-the-counter antibiotics and self-treating self-limiting illnesses with drugs, such as upper-respiratory tract infections without complications, they are likely to suggest that the antibiotic was effective, and self-medicate in the future. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. 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. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations. 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. 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.

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