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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. 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 providing over-the-counter drugs is illegal in the United States, failure to enforce US laws likely encourages these companies to sell their products to patients. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. 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. 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. 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. The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. Several studies suggest that antibiotic prescribing for viral illnesses, respiratory tract infections being one example, has declined in the last decade. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. Fourth, we have limited our count to English language websites. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics.