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This study was not meant to be an exhaustive census of these sites, primarily because with the questionable legality of some of these practices, these sites rapidly come and go. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. First, although all of the included providers would sell antibiotics without a prescription, we assessed whether the supplier would sell antibiotics without any form of prescription or whether a prescription created for the purchase based on the completion of an online medical history was required. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. No prescription was required, and no online consultation was necessary. The vendors identified in this study do not appear to be fearful of prosecution. Fourth, we categorized whether a person could buy antibiotics, especially broad-spectrum antibiotics, in quantities greater than what would be considered adequate 1 course of treatment for acute respiratory tract infection. Unfortunately, other disturbing evidence suggests that this problem may not be easily fixed through education, a troubling issue in controlling antibiotic use. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. Thus, as soon as patients receive over-the-counter antibiotics and self-treating self-limiting illnesses with drugs, such as upper-respiratory tract infections without complications, they are likely to suggest that the antibiotic was effective, and self-medicate in the future. Our study is the first to document this phenomenon, and we describe the mechanism for purchasing antibiotics online; future studies will need to document the scope of antibiotics purchased through this mechanism to better understand its direct implications for antibiotic resistance. 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. 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. Increased regulation of sites outside of controlled substances to include antibiotics seems guaranteed and necessary. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers.