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After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. This activity suggests that some vendors are aware of the questionable legitimacy of their business. Moreover, pharmaceutical companies may need to monitor who is selling their products and through what mechanisms. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. Second, we examined whether the vendor would ship prescription antibiotics to a buyer in the United States, as well as several other countries (Canada, United Kingdom) where antibiotics are available only by prescription. In addition, the ability of Internet-based companies to exist without an identifiable physical location or property makes the location and writing of FDA instructions extremely difficult. This study was not meant to be an exhaustive census of these sites, primarily because with the questionable legality of some of these practices, these sites rapidly come and go. 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. Further education aimed at patients and the community, as well as increased regulation and application of existing guidelines, can help control this potentially vast reservoir of antibiotics. 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. We assessed whether individuals could purchase penicillins, macrolides, fluoroquinolones, and cephalosporins, because the availability of multiple classes of antibiotics would affect additional selective pressure in the community. Our final list of URLs included 184 links to single vendors of 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. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations.

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