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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. 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. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. Our purchase arrived from Mexico with no information on instructions for use of the medication. Patients are increasingly using the Internet not only to access health information but also to obtain medication. 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. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. In usual face-to-face health care visits for respiratory tract infections during which antibiotics are prescribed, more than 90% of prescriptions are filled on the day of the office visit. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. The links to these advertised sites were also investigated. Our final list of URLs included 184 links to single vendors of antibiotics. This phenomenon has not been the focus of initiatives to control antibiotic resistance. 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. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site.