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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. In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. Some prescription medication is sold without a valid prescription, which is a violation of the Federal Food, Drug, and Cosmetic Act. Finally, and potentially the biggest limitation on the importance of this study, is that we were unable to describe how this Internet-based purchasing strategy was used to purchase people with antibiotics in the United States. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. Fourth, we have limited our count to English language websites. The frequency of relevant Web sites declined substantially after the first 300. Our study suggests that the opposite might be the case. 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. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. The first 300 search results of on both sites were examined to identify vendors for antibiotics that did not require a prescription. This activity suggests that some vendors are aware of the questionable legitimacy of their business. This decrease was interpreted as evidence that the full use of antibiotics was also reduced.

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