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Although more than half of the identified sites provided online consultation for prescribing, the lack of interaction between the patient and the doctor did not lead to any opportunity for patient education. 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. The extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. Moreover, pharmaceutical companies may need to monitor who is selling their products and through what mechanisms. Finally, and potentially the biggest limitation on the importance of this study, is that we were unable to describe how this Internet-based purchasing strategy was used to purchase people with antibiotics in the United States. As part of this study, we bought over-the-counter antibiotics over the counter. 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. 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. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. In addition, the ability of Internet-based companies to exist without an identifiable physical location or property makes the location and writing of FDA instructions extremely difficult. If those who are self-medicating are taught that they put their own health at risk, they may be less likely to use these online pharmacies. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer.

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