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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. There are several limitations to this study. 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. Thus, vendors targeting foreign-language speakers in the United States would have been missed. Moreover, pharmaceutical companies may need to monitor who is selling their products and through what mechanisms. In some cases the URL did not take the reader to an actual medication vendor; rather, the Web site contained multiple advertisements and links to other sites for purchasing antibiotics. Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time. Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. All these obstacles cause the illegal acquisition of antibiotics by patients. 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. Although the vast majority of websites were in English, some were in other languages. 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. First, this study provides a sample of websites and providers, and thus may not be indicative of all suppliers selling over-the-counter antibiotics. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. 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. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown.