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Increased regulation of sites outside of controlled substances to include antibiotics seems guaranteed and necessary. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. The frequency of relevant Web sites declined substantially after the first 300. The extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. We classified Web sites of vendors according to several variables. Other providers are trying to upset this law by providing online diagnoses and prescriptions based on medical records without a physical examination and without a long relationship between the patient and the doctor, a practice that is not considered an adequate standard of care. Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations. Clinicians evaluating the patient's use of self-medication when taking a medical history may function as an important opportunity to tell patients about not only antibiotic resistance, but also potential interactions between antibiotics and other prescription drugs. Although the vast majority of websites were in English, some were in other languages. 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. 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.

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