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This practice also occurs in the United States even though the United States regulates the acquisition of antibiotics, which will be limited by prescription only. 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. Although the vast majority of websites were in English, some were in other languages. 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. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. This activity suggests that some vendors are aware of the questionable legitimacy of their business. There are several limitations to this study. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. The extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. 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. Some prescription medication is sold without a valid prescription, which is a violation of the Federal Food, Drug, and Cosmetic Act. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. The medical community and the public health and regulating agencies, as well as pharmaceutical companies, need to expand efforts to control antibiotic resistance beyond initiatives centered on prescribing behavior to include self-medication and sources of antibiotics obtained without prescription. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer.