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Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. Thus, as soon as patients receive over-the-counter antibiotics and self-treating self-limiting illnesses with drugs, such as upper-respiratory tract infections without complications, they are likely to suggest that the antibiotic was effective, and self-medicate in the future. First, although all of the included providers would sell antibiotics without a prescription, we assessed whether the supplier would sell antibiotics without any form of prescription or whether a prescription created for the purchase based on the completion of an online medical history was required. Third, we categorized the classes of antibiotics available for purchase. Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. In usual face-to-face health care visits for respiratory tract infections during which antibiotics are prescribed, more than 90% of prescriptions are filled on the day of the office visit. European countries struggled with the problem of self-medication with antibiotics and found that the belief in the appropriateness of self-medication with antibiotics for bronchitis and the perceived availability of antibiotics without a prescription was associated with an increased likelihood of self-medication. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. We classified Web sites of vendors according to several variables. 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. This decrease was interpreted as evidence that the full use of antibiotics was also reduced. 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. The findings described in this study suggest that there is a potentially large pool of antibiotics in the United States that is not affected by initiatives to change physician-prescribing practices and may be contributing to antibiotic resistance. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting.