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There are several limitations to this study. The extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. Most initiatives, however, focus almost exclusively on controlling prescribing by health care clinicians and do not focus on patient self-medication. The links to these advertised sites were also investigated. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. 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 part of this study, we bought over-the-counter antibiotics over the counter. 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. Second, there was a considerable repetition in the Web sites, which made an accurate determination of unique vendors from the 184 different sites difficult, an effort that may have let to some error. This activity suggests that some vendors are aware of the questionable legitimacy of their business. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. 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.

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