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This phenomenon has not been the focus of initiatives to control antibiotic resistance. Recent evidence in ethnic communities in the United States indicates a high level of self-medication with antibiotics either obtained without a prescription in a foreign country and imported into the United States or acquired in the United States without a prescription at stores in ethnic communities. This reservoir of antibiotics is likely to be used inappropriately-the Web sites promote self-diagnosis and self-medication, and antibiotics are likely to be used in inappropriate dosages. In conclusion, antibiotics are freely available for purchase over the Internet without a prescription, and the general structure of transactions encourages self-medication and poor quality care. Antibiotics serve a useful therapeutic purpose in treating and controlling the effects of infectious agents. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. In usual face-to-face health care visits for respiratory tract infections during which antibiotics are prescribed, more than 90% of prescriptions are filled on the day of the office visit. Moreover, pharmaceutical companies may need to monitor who is selling their products and through what mechanisms. Antibiotic resistance is a common problem, however, and has been described with numerous infectious agents and in varying contexts. We classified Web sites of vendors according to several variables. This activity suggests that some vendors are aware of the questionable legitimacy of their business. We considered more than 6 pills to be excessive and could lead to future self-medication with the unused pills. The extended delay between diagnosis and treatment receipt has consequences for resolving self-limiting conditions and storing unused treatment. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. If patients who are now denied antibiotics through their physician can access over-the-counter medications, the overall level of antibiotic use in the general population can actually increase and thus have a significant effect on rates of resistance to microbial degradation. Fourth, we categorized whether a person could buy antibiotics, especially broad-spectrum antibiotics, in quantities greater than what would be considered adequate 1 course of treatment for acute respiratory tract infection.