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Our final list of URLs included 184 links to single vendors of antibiotics. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. Our study suggests that the opposite might be the case. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. 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. If those who are self-medicating are taught that they put their own health at risk, they may be less likely to use these online pharmacies. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations. Clinicians evaluating the patient's use of self-medication when taking a medical history may function as an important opportunity to tell patients about not only antibiotic resistance, but also potential interactions between antibiotics and other prescription drugs. Several studies suggest that antibiotic prescribing for viral illnesses, respiratory tract infections being one example, has declined in the last decade. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. 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. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. 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.

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