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Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. Most initiatives, however, focus almost exclusively on controlling prescribing by health care clinicians and do not focus on patient self-medication. Some prescription medication is sold without a valid prescription, which is a violation of the Federal Food, Drug, and Cosmetic Act. 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. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. We assessed whether individuals could purchase penicillins, macrolides, fluoroquinolones, and cephalosporins, because the availability of multiple classes of antibiotics would affect additional selective pressure in the community. No prescription was required, and no online consultation was necessary. Third, we categorized the classes of antibiotics available for purchase. This practice also occurs in the United States even though the United States regulates the acquisition of antibiotics, which will be limited by prescription only. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet. As part of this study, we bought over-the-counter antibiotics over the counter. Although providing over-the-counter drugs is illegal in the United States, failure to enforce US laws likely encourages these companies to sell their products to patients. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. Finally, in order to determine whether these sites actually provide a product that they intended to sell over the counter, we submitted an online order to 1 vendor for 6 tablets of azithromycin, 500 mg each. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. 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.