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As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. This decrease was interpreted as evidence that the full use of antibiotics was also reduced. We classified Web sites of vendors according to several variables. Our purchase arrived from Mexico with no information on instructions for use of the medication. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. Further education aimed at patients and the community, as well as increased regulation and application of existing guidelines, can help control this potentially vast reservoir of antibiotics. There are several limitations to this study. 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. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. 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. Fifth, we estimated the expected delivery time to take antibiotics. 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. Self-administration of antibiotics occurs in all countries, but it is particularly problematic where the use of antimicrobials without a prescription is encouraged by the lack of laws restricting antibiotic sales or a failure to enforce the laws.

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