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The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. 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. 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. Second, we examined whether the vendor would ship prescription antibiotics to a buyer in the United States, as well as several other countries (Canada, United Kingdom) where antibiotics are available only by prescription. We classified Web sites of vendors according to several variables. Although excessive consumption of antibiotics has contributed to the spread of antibiotic resistance, 4-6 most initiatives regarding inappropriate direct human consumption of the antibiotic therapy center are almost exclusively controlled by prescribing by healthcare clinicians. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. To examine the types of Web sites and vendors dispensing antibiotics on the Internet, we conducted a search using 2 major search engines (Google and Yahoo) and the key words "purchase antibiotics without prescription" and "online (English only). This decrease was interpreted as evidence that the full use of antibiotics was also reduced. Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations. Thus, vendors targeting foreign-language speakers in the United States would have been missed. In some cases the URL did not take the reader to an actual medication vendor; rather, the Web site contained multiple advertisements and links to other sites for purchasing antibiotics.

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