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Our study suggests that the opposite might be the case. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. The frequency of relevant Web sites declined substantially after the first 300. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication. 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. Our purchase arrived from Mexico with no information on instructions for use of the medication. The links to these advertised sites were also investigated. There are several limitations to this study. Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. 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. All these obstacles cause the illegal acquisition of antibiotics by patients. For example, we found that servers at Dartmouth College, East Carolina University, University of Pittsburgh, Carnegie Mellon University, and California State University in San Francisco were all used, most likely without their knowledge, to be reassigned to online pharmacies. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet. Clinicians evaluating the patient's use of self-medication when taking a medical history may function as an important opportunity to tell patients about not only antibiotic resistance, but also potential interactions between antibiotics and other prescription drugs. 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.