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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. This activity suggests that some vendors are aware of the questionable legitimacy of their business. 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. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. We assessed whether individuals could purchase penicillins, macrolides, fluoroquinolones, and cephalosporins, because the availability of multiple classes of antibiotics would affect additional selective pressure in the community. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting. 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. As part of this study, we bought over-the-counter antibiotics over the counter. Third, we categorized the classes of antibiotics available for purchase. Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. Unfortunately, other disturbing evidence suggests that this problem may not be easily fixed through education, a troubling issue in controlling antibiotic use. 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. This study was not meant to be an exhaustive census of these sites, primarily because with the questionable legality of some of these practices, these sites rapidly come and go.