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This activity suggests that some vendors are aware of the questionable legitimacy of their business. 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. Patients are increasingly using the Internet not only to access health information but also to obtain medication. 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. Fourth, we have limited our count to English language websites. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. If those who are self-medicating are taught that they put their own health at risk, they may be less likely to use these online pharmacies. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer. The extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. Some prescription medication is sold without a valid prescription, which is a violation of the Federal Food, Drug, and Cosmetic Act. 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. First, this study provides a sample of websites and providers, and thus may not be indicative of all suppliers selling over-the-counter antibiotics. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. 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.