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The frequency of relevant Web sites declined substantially after the first 300. Fourth, we have limited our count to English language websites. This practice also occurs in the United States even though the United States regulates the acquisition of antibiotics, which will be limited by prescription only. Although the vast majority of websites were in English, some were in other languages. First, this study provides a sample of websites and providers, and thus may not be indicative of all suppliers selling over-the-counter antibiotics. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. The links to these advertised sites were also investigated. Although more than half of the identified sites provided online consultation for prescribing, the lack of interaction between the patient and the doctor did not lead to any opportunity for patient education. 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. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. Finally, in order to determine whether these sites actually provide a product that they intended to sell over the counter, we submitted an online order to 1 vendor for 6 tablets of azithromycin, 500 mg each. No prescription was required, and no online consultation was necessary. There are several limitations to this study. Our study suggests that the opposite might be the case.