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Some Internet vendors also attempt to skirt US regulations by operating in countries outside the United States but marketing to US consumers. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet. The frequency of relevant Web sites declined substantially after the first 300. Since the websites suggested a range of days for the expected treatment receipt, we used the median to represent the expected delivery time. In the case of online histories to justify a prescription, we assumed that individuals are primarily purchasing antibiotics for an acute problem. 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. Although providing over-the-counter drugs is illegal in the United States, failure to enforce US laws likely encourages these companies to sell their products to patients. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. 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. Some prescription medication is sold without a valid prescription, which is a violation of the Federal Food, Drug, and Cosmetic Act. 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. For this second group, no prescription from a doctor or clinical physician was necessary before gaining access to the site. Even with these strategies, however, it was difficult to know whether one corporation still owns and manages several locations. Specifically, we classified a single course of azithromycin as 6 pills, 250 mg each. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections.

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