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In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. Thus, vendors targeting foreign-language speakers in the United States would have been missed. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. As part of this study, we bought over-the-counter antibiotics over the counter. The medical community and the public health and regulating agencies, as well as pharmaceutical companies, need to expand efforts to control antibiotic resistance beyond initiatives centered on prescribing behavior to include self-medication and sources of antibiotics obtained without prescription. Although providing over-the-counter drugs is illegal in the United States, failure to enforce US laws likely encourages these companies to sell their products to patients. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. Some prescription medication is sold without a valid prescription, which is a violation of the Federal Food, Drug, and Cosmetic Act. There are several limitations to this study. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. This decrease was interpreted as evidence that the full use of antibiotics was also reduced. This reservoir of antibiotics is likely to be used inappropriately-the Web sites promote self-diagnosis and self-medication, and antibiotics are likely to be used in inappropriate dosages. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting. Fifth, we estimated the expected delivery time to take antibiotics.

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