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Fourth, we categorized whether a person could buy antibiotics, especially broad-spectrum antibiotics, in quantities greater than what would be considered adequate 1 course of treatment for acute respiratory tract infection. Thus, vendors targeting foreign-language speakers in the United States would have been missed. Unfortunately, other disturbing evidence suggests that this problem may not be easily fixed through education, a troubling issue in controlling antibiotic use. This decrease was interpreted as evidence that the full use of antibiotics was also reduced. In addition, the available quantities and the interval between prescribing and receiving treatment suggest that these transactions will likely be used by people storing drugs for future self-diagnosis and treatment, or for sale. Our study suggests that the opposite might be the case. Most initiatives, however, focus almost exclusively on controlling prescribing by health care clinicians and do not focus on patient self-medication. 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. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. 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. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. Fifth, we estimated the expected delivery time to take antibiotics. There are several limitations to this study. Although the vast majority of websites were in English, some were in other languages.

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