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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 patients who are now denied antibiotics through their physician can access over-the-counter medications, the overall level of antibiotic use in the general population can actually increase and thus have a significant effect on rates of resistance to microbial degradation. 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. The vendors identified in this study do not appear to be fearful of prosecution. In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations. For example, we found that servers at Dartmouth College, East Carolina University, University of Pittsburgh, Carnegie Mellon University, and California State University in San Francisco were all used, most likely without their knowledge, to be reassigned to online pharmacies. Although more than half of the identified sites provided online consultation for prescribing, the lack of interaction between the patient and the doctor did not lead to any opportunity for patient education. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. 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. This phenomenon has not been the focus of initiatives to control antibiotic resistance. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. Several studies suggest that antibiotic prescribing for viral illnesses, respiratory tract infections being one example, has declined in the last decade. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer.