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Our study suggests that the opposite might be the case. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer. For example, we found that servers at Dartmouth College, East Carolina University, University of Pittsburgh, Carnegie Mellon University, and California State University in San Francisco were all used, most likely without their knowledge, to be reassigned to online pharmacies. We considered more than 6 pills to be excessive and could lead to future self-medication with the unused pills. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting. 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 compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. Second, we examined whether the vendor would ship prescription antibiotics to a buyer in the United States, as well as several other countries (Canada, United Kingdom) where antibiotics are available only by prescription. Although the vast majority of websites were in English, some were in other languages. 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. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. No prescription was required, and no online consultation was necessary. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed.

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