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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. Moreover, pharmaceutical companies may need to monitor who is selling their products and through what mechanisms. Increased regulation of sites outside of controlled substances to include antibiotics seems guaranteed and necessary. Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. Patients are increasingly using the Internet not only to access health information but also to obtain medication. 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. The frequency of relevant Web sites declined substantially after the first 300. This phenomenon has not been the focus of initiatives to control antibiotic resistance. 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 findings described in this study suggest that there is a potentially large pool of antibiotics in the United States that is not affected by initiatives to change physician-prescribing practices and may be contributing to antibiotic resistance. The links to these advertised sites were also investigated. 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. 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. The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. 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. In addition, the available quantities and the interval between prescribing and receiving treatment suggest that these transactions will likely be used by people storing drugs for future self-diagnosis and treatment, or for sale.