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The extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. 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. Third, we categorized the classes of antibiotics available for purchase. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. 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 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. No prescription was required, and no online consultation was necessary. Thus, as soon as patients receive over-the-counter antibiotics and self-treating self-limiting illnesses with drugs, such as upper-respiratory tract infections without complications, they are likely to suggest that the antibiotic was effective, and self-medicate in the future. 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. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. Although the vast majority of websites were in English, some were in other languages. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. 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.

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