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Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. In addition, the ability of Internet-based companies to exist without an identifiable physical location or property makes the location and writing of FDA instructions extremely difficult. The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. Although excessive consumption of antibiotics has contributed to the spread of antibiotic resistance, 4-6 most initiatives regarding inappropriate direct human consumption of the antibiotic therapy center are almost exclusively controlled by prescribing by healthcare clinicians. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting. The vendors identified in this study do not appear to be fearful of prosecution. Our final list of URLs included 184 links to single vendors of antibiotics. 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. Recent evidence in ethnic communities in the United States indicates a high level of self-medication with antibiotics either obtained without a prescription in a foreign country and imported into the United States or acquired in the United States without a prescription at stores in ethnic communities. Second, we examined whether the vendor would ship prescription antibiotics to a buyer in the United States, as well as several other countries (Canada, United Kingdom) where antibiotics are available only by prescription. 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. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. There are several limitations to this study. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer.

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