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Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. Other providers are trying to upset this law by providing online diagnoses and prescriptions based on medical records without a physical examination and without a long relationship between the patient and the doctor, a practice that is not considered an adequate standard of care. 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. 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. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. The links to these advertised sites were also investigated. 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. We classified Web sites of vendors according to several variables. 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. No prescription was required, and no online consultation was necessary. 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. 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. Thus, vendors targeting foreign-language speakers in the United States would have been missed. Although excessive consumption of antibiotics has contributed to the spread of antibiotic resistance, 4-6 most initiatives regarding inappropriate direct human consumption of the antibiotic therapy center are almost exclusively controlled by prescribing by healthcare clinicians.

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