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Our study suggests that the opposite might be the case. Our purchase arrived from Mexico with no information on instructions for use of the medication. We classified Web sites of vendors according to several variables. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer. In conclusion, antibiotics are freely available for purchase over the Internet without a prescription, and the general structure of transactions encourages self-medication and poor quality care. In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. 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. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. Moreover, pharmaceutical companies may need to monitor who is selling their products and through what mechanisms. For example, we found that servers at Dartmouth College, East Carolina University, University of Pittsburgh, Carnegie Mellon University, and California State University in San Francisco were all used, most likely without their knowledge, to be reassigned to online pharmacies. 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. Unfortunately, other disturbing evidence suggests that this problem may not be easily fixed through education, a troubling issue in controlling antibiotic use. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed.

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