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The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. 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. 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. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. This phenomenon has not been the focus of initiatives to control antibiotic resistance. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet. 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. 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. European countries struggled with the problem of self-medication with antibiotics and found that the belief in the appropriateness of self-medication with antibiotics for bronchitis and the perceived availability of antibiotics without a prescription was associated with an increased likelihood of self-medication. All these obstacles cause the illegal acquisition of antibiotics by patients. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. 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. Recent evidence in ethnic communities in the United States indicates a high level of self-medication with antibiotics either obtained without a prescription in a foreign country and imported into the United States or acquired in the United States without a prescription at stores in ethnic communities.