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There are several limitations to this study. In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. 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 Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. 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. Fifth, we estimated the expected delivery time to take antibiotics. 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. We considered more than 6 pills to be excessive and could lead to future self-medication with the unused pills. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. Our purchase arrived from Mexico with no information on instructions for use of the medication. 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. Although the vast majority of websites were in English, some were in other languages. To examine the types of Web sites and vendors dispensing antibiotics on the Internet, we conducted a search using 2 major search engines (Google and Yahoo) and the key words "purchase antibiotics without prescription" and "online (English only). Moreover, pharmaceutical companies may need to monitor who is selling their products and through what mechanisms.