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The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. 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. Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. 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. 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. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. First, this study provides a sample of websites and providers, and thus may not be indicative of all suppliers selling over-the-counter antibiotics. Fourth, we categorized whether a person could buy antibiotics, especially broad-spectrum antibiotics, in quantities greater than what would be considered adequate 1 course of treatment for acute respiratory tract infection. In addition, the available quantities and the interval between prescribing and receiving treatment suggest that these transactions will likely be used by people storing drugs for future self-diagnosis and treatment, or for sale. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics.

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