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The frequency of relevant Web sites declined substantially after the first 300. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. 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. 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). 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. 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. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. Several studies suggest that antibiotic prescribing for viral illnesses, respiratory tract infections being one example, has declined in the last decade. Thus, vendors targeting foreign-language speakers in the United States would have been missed. All these obstacles cause the illegal acquisition of antibiotics by patients. No prescription was required, and no online consultation was necessary. Patients are increasingly using the Internet not only to access health information but also to obtain medication. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior.