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In addition, the ability of Internet-based companies to exist without an identifiable physical location or property makes the location and writing of FDA instructions extremely difficult. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. This phenomenon has not been the focus of initiatives to control antibiotic resistance. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. Second, there was a considerable repetition in the Web sites, which made an accurate determination of unique vendors from the 184 different sites difficult, an effort that may have let to some error. The findings described in this study suggest that there is a potentially large pool of antibiotics in the United States that is not affected by initiatives to change physician-prescribing practices and may be contributing to antibiotic resistance. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. 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. First, this study provides a sample of websites and providers, and thus may not be indicative of all suppliers selling over-the-counter antibiotics. To examine the types of Web sites and vendors dispensing antibiotics on the Internet, we conducted a search using 2 major search engines (Google and Yahoo) and the key words "purchase antibiotics without prescription" and "online (English only). Our final list of URLs included 184 links to single vendors of antibiotics. Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations. Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. Thus, vendors targeting foreign-language speakers in the United States would have been missed.