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All these obstacles cause the illegal acquisition of antibiotics by patients. The vendors identified in this study do not appear to be fearful of prosecution. No prescription was required, and no online consultation was necessary. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. The extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. The findings described in this study suggest that there is a potentially large pool of antibiotics in the United States that is not affected by initiatives to change physician-prescribing practices and may be contributing to antibiotic resistance. Several studies suggest that antibiotic prescribing for viral illnesses, respiratory tract infections being one example, has declined in the last decade. Finally, in order to determine whether these sites actually provide a product that they intended to sell over the counter, we submitted an online order to 1 vendor for 6 tablets of azithromycin, 500 mg each. Our purchase arrived from Mexico with no information on instructions for use of the medication. Because of its effect on morbidity and mortality, antibiotic resistance is considered a threat to US health and national security by the Institute of Medicine and the Infectious Diseases Society of America. Fifth, we estimated the expected delivery time to take antibiotics. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer. This reservoir of antibiotics is likely to be used inappropriately-the Web sites promote self-diagnosis and self-medication, and antibiotics are likely to be used in inappropriate dosages. The links to these advertised sites were also investigated. Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time.