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Thus, as soon as patients receive over-the-counter antibiotics and self-treating self-limiting illnesses with drugs, such as upper-respiratory tract infections without complications, they are likely to suggest that the antibiotic was effective, and self-medicate in the future. 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. No prescription was required, and no online consultation was necessary. This phenomenon has not been the focus of initiatives to control antibiotic resistance. Increased regulation of sites outside of controlled substances to include antibiotics seems guaranteed and necessary. 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. In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. The extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. The frequency of relevant Web sites declined substantially after the first 300. 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. 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. Unfortunately, other disturbing evidence suggests that this problem may not be easily fixed through education, a troubling issue in controlling antibiotic use. 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. First, this study provides a sample of websites and providers, and thus may not be indicative of all suppliers selling over-the-counter antibiotics. First, although all of the included providers would sell antibiotics without a prescription, we assessed whether the supplier would sell antibiotics without any form of prescription or whether a prescription created for the purchase based on the completion of an online medical history was required.