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The links to these advertised sites were also investigated. Third, we categorized the classes of antibiotics available for purchase. 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. 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. This activity suggests that some vendors are aware of the questionable legitimacy of their business. Our study suggests that the opposite might be the case. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. This reservoir of antibiotics is likely to be used inappropriately-the Web sites promote self-diagnosis and self-medication, and antibiotics are likely to be used in inappropriate dosages. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. 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. This decrease was interpreted as evidence that the full use of antibiotics was also reduced.

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