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In addition, the ability of Internet-based companies to exist without an identifiable physical location or property makes the location and writing of FDA instructions extremely difficult. Although the vast majority of websites were in English, some were in other languages. 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. Second, there was a considerable repetition in the Web sites, which made an accurate determination of unique vendors from the 184 different sites difficult, an effort that may have let to some error. Third, we categorized the classes of antibiotics available for purchase. Several studies suggest that antibiotic prescribing for viral illnesses, respiratory tract infections being one example, has declined in the last decade. Patients are increasingly using the Internet not only to access health information but also to obtain medication. Increased regulation of sites outside of controlled substances to include antibiotics seems guaranteed and necessary. 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. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. We assessed whether individuals could purchase penicillins, macrolides, fluoroquinolones, and cephalosporins, because the availability of multiple classes of antibiotics would affect additional selective pressure in the community. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. In addition, the available quantities and the interval between prescribing and receiving treatment suggest that these transactions will likely be used by people storing drugs for future self-diagnosis and treatment, or for sale. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. 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. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet.