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Thus, vendors targeting foreign-language speakers in the United States would have been missed. Most initiatives, however, focus almost exclusively on controlling prescribing by health care clinicians and do not focus on patient self-medication. As part of this study, we bought over-the-counter antibiotics over the counter. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. In usual face-to-face health care visits for respiratory tract infections during which antibiotics are prescribed, more than 90% of prescriptions are filled on the day of the office visit. The findings described in this study suggest that there is a potentially large pool of antibiotics in the United States that is not affected by initiatives to change physician-prescribing practices and may be contributing to antibiotic resistance. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. 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. Moreover, pharmaceutical companies may need to monitor who is selling their products and through what mechanisms. First, although all of the included providers would sell antibiotics without a prescription, we assessed whether the supplier would sell antibiotics without any form of prescription or whether a prescription created for the purchase based on the completion of an online medical history was required. We considered more than 6 pills to be excessive and could lead to future self-medication with the unused pills. 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. 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. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. The vendors identified in this study do not appear to be fearful of prosecution.