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Fourth, we have limited our count to English language websites. Patients are increasingly using the Internet not only to access health information but also to obtain medication. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. 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. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. This decrease was interpreted as evidence that the full use of antibiotics was also reduced. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. Increased regulation of sites outside of controlled substances to include antibiotics seems guaranteed and necessary. The frequency of relevant Web sites declined substantially after the first 300. The US Food and Drug Administration forbids ordering prescription drugs from outside the United States: Thus, in virtually all instances, individual citizens are prohibited from importing prescription drugs into the United States. The links to these advertised sites were also investigated. In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. 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. 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. The medical community and the public health and regulating agencies, as well as pharmaceutical companies, need to expand efforts to control antibiotic resistance beyond initiatives centered on prescribing behavior to include self-medication and sources of antibiotics obtained without prescription. There are several limitations to this study.