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Clinicians evaluating the patient's use of self-medication when taking a medical history may function as an important opportunity to tell patients about not only antibiotic resistance, but also potential interactions between antibiotics and other prescription drugs. Fourth, we have limited our count to English language websites. Our study is the first to document this phenomenon, and we describe the mechanism for purchasing antibiotics online; future studies will need to document the scope of antibiotics purchased through this mechanism to better understand its direct implications for antibiotic resistance. Self-administration of antibiotics occurs in all countries, but it is particularly problematic where the use of antimicrobials without a prescription is encouraged by the lack of laws restricting antibiotic sales or a failure to enforce the 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. The frequency of relevant Web sites declined substantially after the first 300. Patients are increasingly using the Internet not only to access health information but also to obtain medication. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer. 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 extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. 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). Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. This decrease was interpreted as evidence that the full use of antibiotics was also reduced. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics.

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