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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. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting. 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. This phenomenon has not been the focus of initiatives to control antibiotic resistance. The links to these advertised sites were also investigated. Patients are increasingly using the Internet not only to access health information but also to obtain medication. Unfortunately, other disturbing evidence suggests that this problem may not be easily fixed through education, a troubling issue in controlling antibiotic use. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. Our study suggests that the opposite might be the case. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. This activity suggests that some vendors are aware of the questionable legitimacy of their business. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. 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.