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Our final list of URLs included 184 links to single vendors of antibiotics. 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. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. 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. 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. Fifth, we estimated the expected delivery time to take antibiotics. 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. Our study suggests that the opposite might be the case. In some cases the URL did not take the reader to an actual medication vendor; rather, the Web site contained multiple advertisements and links to other sites for purchasing antibiotics. Several studies suggest that antibiotic prescribing for viral illnesses, respiratory tract infections being one example, has declined in the last decade. 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 first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. 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. No prescription was required, and no online consultation was necessary. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. Increased regulation of sites outside of controlled substances to include antibiotics seems guaranteed and necessary.

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