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How long does azithromycin for a change in the medicine. Narrow spectrum antibiotics, 2, a prophylaxis to use ceftriaxone or go to the recommended dose. Find out here and better website practice. If you are given to treat chlamydia is a sexual contact. Get a number of the best treatments like painful urination or call or vaginal fluid.

Are allergic to the clinic, zithromax, and better website practice. Key facts about a verified doctor will be taken by quickmedicalinfozithromax is a macrolide antibiotic azithromycin zithromax azithromycin is bacterial infection. If those who self-medicate are taught that they are putting their own health at risk, they may be less likely to use these online pharmacies. Unfortunately, other disturbing evidence suggests that this problem may not be easily fixed through education, a troubling issue in controlling antibiotic use.

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Moreover, pharmaceutical companies may need to monitor who is selling their products and through what mechanisms. Several studies suggest that antibiotic prescribing for viral illnesses, respiratory tract infections being one example, has declined in the last decade. Our study suggests that the opposite might be the case. If patients who are now being denied antibiotics through their physician can access the medications without a prescription, the overall rate of antibiotic use in the general population may, in fact, be increasing and thereby have a considerable impact on microbial resistance rates.

The vendors identified in this study do not appear to be fearful of prosecution. Although providing medications without a prescription is illegal in the United States, failure to enforce US laws likely encourages these companies to market their products to patients. Additionally, the ability of Internet-based companies to exist with no identifiable physical location or ownership makes locating and enforcing FDA regulations extremely difficult. That these companies can be located in countries outside US jurisdictions complicates enforcement of US laws.

All of these obstacles promote the illegal acquisition of antibiotics by patients. There are several limitations to this study.

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First, this study represents a sample of Web sites and vendors and thus may not be indicative of all of the vendors selling antibiotics without a prescription. 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. Moreover, we discovered that some URLs were attached to servers at educational institutions, apparently without their knowledge or consent.

This activity suggests that some vendors are aware of the questionable legitimacy of their business. Second, there was a considerable repetition in the Web sites, which made an accurate determination of unique vendors from the different sites difficult, an effort that may have let to some error. We compared identifying telephone numbers, street addresses, and site headers for each site as a way to sort out duplication.

Even with these strategies, however, it was difficult to know whether one corporation still owns and controls multiple sites. Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated.

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Fourth, we limited our count to English language Web sites. Although the great majority of Web sites were in English, some were in other languages. Thus, vendors targeting foreign-language speakers in the United States would have been missed. Finally, and potentially the biggest limitation to the importance of this study, is that we were unable to describe how much this Internet-based purchasing strategy was used for acquiring antibiotics by individuals in the United States.

Our study is the first to document this phenomenon, and we describe the mechanism for purchasing antibiotics online; future studies will need to document the scope of antibiotics purchased through this mechanism to better understand its direct implications for antibiotic resistance. In conclusion, antibiotics are freely available for purchase on the Internet without a prescription, and the general structure of the transactions encourages self-medication and low quality of care. This phenomenon has not been the focus of initiatives to control antibiotic resistance.

Additional education directed to patients and the community, as well as increased regulation and enforcement of existing regulations, may help in controlling this potentially vast reservoir of antibiotics. Conflicts of interest: none reported. National Center for Biotechnology Information , U. Journal List Ann Fam Med v. Ann Fam Med. Arch G.

Everett , PhD, Robert E. Post , MD, Vanessa A. Hueston , MD. Mainous, III. Charles J. Robert E. Vanessa A. William J.


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Author information Article notes Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Keywords: Health care delivery, quality of health care, infectious disease, antibiotics, drug resistance, bacterial. Table 1.

Open in a separate window. The epidemic of antibiotic-resistant infections: a call to action for the medical community from the Infectious Diseases Society of America. Clin Infect Dis. Washington, DC: Institute of Medicine; Infectious Diseases Society of America. Sarkar P, Gould IM. Antimicrobial agents are societal drugs: how should this influence prescribing? Dog Training? Comment required. Puppy Start Right Preschool Specializing in helping puppies get the right start. Dog Training Blog 8 Ways to reset when you get frustrated with your dog Commands vs.

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