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Finally, and potentially the biggest limitation on the importance of this study, is that we were unable to describe how this Internet-based purchasing strategy was used to purchase people with antibiotics in the United States. To examine the types of Web sites and vendors dispensing antibiotics on the Internet, we conducted a search using 2 major search engines (Google and Yahoo) and the key words "purchase antibiotics without prescription" and "online (English only). Fourth, we have limited our count to English language websites. Our study suggests that the opposite might be the case. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet. First, this study provides a sample of websites and providers, and thus may not be indicative of all suppliers selling over-the-counter antibiotics. The vendors identified in this study do not appear to be fearful of prosecution. This decrease was interpreted as evidence that the full use of antibiotics was also reduced. The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. In conclusion, antibiotics are freely available for purchase over the Internet without a prescription, and the general structure of transactions encourages self-medication and poor quality care. 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. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. 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.