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Several studies suggest that antibiotic prescribing for viral illnesses, respiratory tract infections being one example, has declined in the last decade. 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. Fifth, we estimated the expected delivery time to take antibiotics. 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, 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. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. 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. Fourth, we categorized whether a person could buy antibiotics, especially broad-spectrum antibiotics, in quantities greater than what would be considered adequate 1 course of treatment for acute respiratory tract infection. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. This decrease was interpreted as evidence that the full use of antibiotics was also reduced. Although providing over-the-counter drugs is illegal in the United States, failure to enforce US laws likely encourages these companies to sell their products to patients. Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations. The links to these advertised sites were also investigated. 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.

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