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Patients are increasingly using the Internet not only to access health information but also to obtain medication. The extent to which antibiotics are available for over-the-counter purchases over the Internet is unknown. If those who are self-medicating are taught that they put their own health at risk, they may be less likely to use these online pharmacies. 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. As websites appear and disappear at a relative frequency, searches and classifications were performed during the first week of September 2008. This practice also occurs in the United States even though the United States regulates the acquisition of antibiotics, which will be limited by prescription only. Fifth, we estimated the expected delivery time to take antibiotics. All these obstacles cause the illegal acquisition of antibiotics by patients. Previous research suggests that a patient's past experience of care seeking and treatment use influences future expectations for treatment of respiratory tract infections. After completing the online medical history, the customer would be given a prescription that would allow the purchase to be completed. Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. 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 activity suggests that some vendors are aware of the questionable legitimacy of their business. Self-administration of antibiotics occurs in all countries, but it is particularly problematic where the use of antimicrobials without a prescription is encouraged by the lack of laws restricting antibiotic sales or a failure to enforce the laws. 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.