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All these obstacles cause the illegal acquisition of antibiotics by patients. First, this study provides a sample of websites and providers, and thus may not be indicative of all suppliers selling over-the-counter antibiotics. 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. The extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. 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. 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. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. No prescription was required, and no online consultation was necessary. Fourth, we have limited our count to English language websites. 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. 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. This activity suggests that some vendors are aware of the questionable legitimacy of their business. 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. 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. Third, we categorized the classes of antibiotics available for purchase.