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The frequency of relevant Web sites declined substantially after the first 300. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. The links to these advertised sites were also investigated. Some prescription medication is sold without a valid prescription, which is a violation of the Federal Food, Drug, and Cosmetic Act. All these obstacles cause the illegal acquisition of antibiotics by patients. Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time. Most initiatives, however, focus almost exclusively on controlling prescribing by health care clinicians and do not focus on patient self-medication. Patients are increasingly using the Internet not only to access health information but also to obtain medication. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet. In addition, the available quantities and the interval between prescribing and receiving treatment suggest that these transactions will likely be used by people storing drugs for future self-diagnosis and treatment, or for sale. 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. 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. 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. 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. European countries struggled with the problem of self-medication with antibiotics and found that the belief in the appropriateness of self-medication with antibiotics for bronchitis and the perceived availability of antibiotics without a prescription was associated with an increased likelihood of self-medication.

St. Thomas the Apostle