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Thus, vendors targeting foreign-language speakers in the United States would have been missed. Fifth, we estimated the expected delivery time to take antibiotics. Although the vast majority of websites were in English, some were in other languages. If patients who are now denied antibiotics through their physician can access over-the-counter medications, the overall level of antibiotic use in the general population can actually increase and thus have a significant effect on rates of resistance to microbial degradation. 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. Patients are increasingly using the Internet not only to access health information but also to obtain medication. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet. 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. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. 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. 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. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. Our purchase arrived from Mexico with no information on instructions for use of the medication. The frequency of relevant Web sites declined substantially after the first 300. Recent evidence in ethnic communities in the United States indicates a high level of self-medication with antibiotics either obtained without a prescription in a foreign country and imported into the United States or acquired in the United States without a prescription at stores in ethnic communities.