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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. To examine the types of Web sites and vendors dispensing antibiotics on the Internet, we conducted a search using 2 major search engines (Google and Yahoo) and the key words "purchase antibiotics without prescription" and "online (English only). The US Food and Drug Administration forbids ordering prescription drugs from outside the United States: Thus, in virtually all instances, individual citizens are prohibited from importing prescription drugs into the United States. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. As part of this study, we bought over-the-counter antibiotics over the counter. We considered more than 6 pills to be excessive and could lead to future self-medication with the unused pills. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting. Although providing over-the-counter drugs is illegal in the United States, failure to enforce US laws likely encourages these companies to sell their products to patients. The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. 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. First, this study provides a sample of websites and providers, and thus may not be indicative of all suppliers selling over-the-counter antibiotics. Fourth, we have limited our count to English language websites. Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time. Several studies suggest that antibiotic prescribing for viral illnesses, respiratory tract infections being one example, has declined in the last decade. The frequency of relevant Web sites declined substantially after the first 300.