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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. 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, 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. The frequency of relevant Web sites declined substantially after the first 300. Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. As part of this study, we bought over-the-counter antibiotics over the counter. 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. 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. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer. This decrease was interpreted as evidence that the full use of antibiotics was also reduced. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting.

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