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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. No prescription was required, and no online consultation was necessary. Unfortunately, other disturbing evidence suggests that this problem may not be easily fixed through education, a troubling issue in controlling antibiotic use. Most initiatives, however, focus almost exclusively on controlling prescribing by health care clinicians and do not focus on patient self-medication. 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. 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. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting. Moreover, pharmaceutical companies may need to monitor who is selling their products and through what mechanisms. Finally, in order to determine whether these sites actually provide a product that they intended to sell over the counter, we submitted an online order to 1 vendor for 6 tablets of azithromycin, 500 mg each. This phenomenon has not been the focus of initiatives to control antibiotic resistance. 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. The extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. Increased regulation of sites outside of controlled substances to include antibiotics seems guaranteed and necessary. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. If patients who are now denied antibiotics through their physician can access over-the-counter medications, the overall level of antibiotic use in the general population can actually increase and thus have a significant effect on rates of resistance to microbial degradation.