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There are several limitations to this study. Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. Fifth, we estimated the expected delivery time to take antibiotics. 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. Our study is the first to document this phenomenon, and we describe the mechanism for purchasing antibiotics online; future studies will need to document the scope of antibiotics purchased through this mechanism to better understand its direct implications for antibiotic resistance. 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. The vendors identified in this study do not appear to be fearful of prosecution. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet. 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. 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. Our final list of URLs included 184 links to single vendors of antibiotics. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. The US Food and Drug Administration forbids ordering prescription drugs from outside the United States: Thus, in virtually all instances, individual citizens are prohibited from importing prescription drugs into the United States.