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This activity suggests that some vendors are aware of the questionable legitimacy of their business. Our study suggests that the opposite might be the case. Although excessive consumption of antibiotics has contributed to the spread of antibiotic resistance, 4-6 most initiatives regarding inappropriate direct human consumption of the antibiotic therapy center are almost exclusively controlled by prescribing by healthcare clinicians. 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. Fifth, we estimated the expected delivery time to take antibiotics. For example, we found that servers at Dartmouth College, East Carolina University, University of Pittsburgh, Carnegie Mellon University, and California State University in San Francisco were all used, most likely without their knowledge, to be reassigned to online pharmacies. Patients are increasingly using the Internet not only to access health information but also to obtain medication. 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. 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. The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. First, although all of the included providers would sell antibiotics without a prescription, we assessed whether the supplier would sell antibiotics without any form of prescription or whether a prescription created for the purchase based on the completion of an online medical history was required. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting. Thus, vendors targeting foreign-language speakers in the United States would have been missed.

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