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Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. Our final list of URLs included 184 links to single vendors of antibiotics. Finally, and potentially the biggest limitation on the importance of this study, is that we were unable to describe how this Internet-based purchasing strategy was used to purchase people with antibiotics in the United States. Our study suggests that the opposite might be the case. No prescription was required, and no online consultation was necessary. Because of its effect on morbidity and mortality, antibiotic resistance is considered a threat to US health and national security by the Institute of Medicine and the Infectious Diseases Society of America. 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. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. 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. Further education aimed at patients and the community, as well as increased regulation and application of existing guidelines, can help control this potentially vast reservoir of antibiotics. 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. 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. This activity suggests that some vendors are aware of the questionable legitimacy of their business. There are several limitations to this study. Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations.