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No prescription was required, and no online consultation was necessary. 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. As some vendors have multiple URLs to reach their company, we checked the mailing address, title and phone number to avoid double counting. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. Patients are increasingly using the Internet not only to access health information but also to obtain medication. The links to these advertised sites were also investigated. This activity suggests that some vendors are aware of the questionable legitimacy of their business. We therefore wanted to find out if the amount of time between online evaluation and getting treatment was significantly longer. Finally, in order to determine whether these sites actually provide a product that they intended to sell over the counter, we submitted an online order to 1 vendor for 6 tablets of azithromycin, 500 mg each. 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. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. 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. 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. In our analysis of evidence of the concept of buying 6 tablets of azithromycin, 500 mg each. 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. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated.