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As part of this study, we bought over-the-counter antibiotics over the counter. 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. 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. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet. 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. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. Fifth, we estimated the expected delivery time to take antibiotics. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. Finally, and potentially the biggest limitation on the importance of this study, is that we were unable to describe how this Internet-based purchasing strategy was used to purchase people with antibiotics in the United States. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. The links to these advertised sites were also investigated. In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. The frequency of relevant Web sites declined substantially after the first 300. 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.