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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 classified Web sites of vendors according to several variables. 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. 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. Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. 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. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. No prescription was required, and no online consultation was necessary. 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. This study was not meant to be an exhaustive census of these sites, primarily because with the questionable legality of some of these practices, these sites rapidly come and go. Several studies suggest that antibiotic prescribing for viral illnesses, respiratory tract infections being one example, has declined in the last decade. First, this study provides a sample of websites and providers, and thus may not be indicative of all suppliers selling over-the-counter antibiotics.

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