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There are several limitations to this study. Although more than half of the identified sites provided online consultation for prescribing, the lack of interaction between the patient and the doctor did not lead to any opportunity for patient education. Our study suggests that the opposite might be the case. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. Fifth, we estimated the expected delivery time to take antibiotics. Our purchase arrived from Mexico with no information on instructions for use of the medication. European countries struggled with the problem of self-medication with antibiotics and found that the belief in the appropriateness of self-medication with antibiotics for bronchitis and the perceived availability of antibiotics without a prescription was associated with an increased likelihood of self-medication. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. Patients are increasingly using the Internet not only to access health information but also to obtain medication. 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. As part of this study, we bought over-the-counter antibiotics over the counter. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. Most initiatives, however, focus almost exclusively on controlling prescribing by health care clinicians and do not focus on patient self-medication. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics.

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