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In addition, the available quantities and the interval between prescribing and receiving treatment suggest that these transactions will likely be used by people storing drugs for future self-diagnosis and treatment, or for sale. Other providers are trying to upset this law by providing online diagnoses and prescriptions based on medical records without a physical examination and without a long relationship between the patient and the doctor, a practice that is not considered an adequate standard of care. Fourth, we have limited our count to English language websites. 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. Our study suggests that the opposite might be the case. 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. Unfortunately, other disturbing evidence suggests that this problem may not be easily fixed through education, a troubling issue in controlling antibiotic use. As a result, most community assessments of antibiotic reservoirs are based on assessments by prescribing clinician behavior. We classified Web sites of vendors according to several variables. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. Although the vast majority of websites were in English, some were in other languages. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. Our purchase arrived from Mexico with no information on instructions for use of the medication. There are several limitations to this study. Several studies suggest that antibiotic prescribing for viral illnesses, respiratory tract infections being one example, has declined in the last decade. Thus, vendors targeting foreign-language speakers in the United States would have been missed.