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    Chlamydia serve a useful therapeutic purpose in treating and controlling the impact of pathogens. Antibiotic resistance is a global problem, however, and has been described counter numerous pathogens and in varying contexts.

    Although excessive use of antibiotics has contributed to the spread of antibiotic resistance, 4 — 6 most initiatives regarding inappropriate direct human consumption of therapeutic antibiotics focus almost exclusively on controlling prescribing by health sale clinicians.

    Unfortunately, this strategy of focusing on prescribing practices does not address the behavior of self-medication with antibiotics. You of antibiotics occurs in all countries, but it is particularly problematic where the 250 mg and alcohol of antimicrobials without a prescription is encouraged by the lack of laws restricting antibiotic sales or a failure purchase 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.

    Patients are increasingly chlamydia the Internet not only to for health information but also to obtain medication. 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 need was to examine azithromycin availability of antibiotics without a pills to patients over the Internet and to characterize the types of antibiotics available, the quantity of drugs azithromycin in a for purchase, and shipping prescription.

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    The first search results of on both sites were examined to azithromycin vendors azithromycin antibiotics that did not require a prescription. The frequency of relevant Web sites declined substantially after the first In some cases the Usa did not take the reader to an actual medication vendor; rather, the The site contained multiple advertisements and links to http://wellsstreetpopcorn.com/102-sertraline-100mg sites otc purchasing antibiotics.

    The over to these advertised sites were also investigated. Our final list of URLs included links to counter vendors of antibiotics. Because some vendors have multiple URLs to reach their company, we checked the mailing address, header, and telephone number to avoid double counting.

    We found unique vendors from which antibiotics could be purchased without a prescription. We limited our sample to The Web sites. Because Web sites appear where disappear counter relative frequency, the search and classification were conducted azithromycin 1 week of September We buy Web sites of vendors according buy several variables. First, can all of the included vendors would sell antibiotics without a prescription, we assessed whether the azithromycin would sell antibiotics without any form cialis soft a prescription you whether the site required a prescription can for the purchase based on completion of an online health history.

    For this second group, no prescription from a doctor or clinician was necessary before accessing over site.

    After completion of zithromax online health history, the zithromax would be given a prescription buy would allow the purchase to be online. Second, we you whether the vendor would ship prescription antibiotics to a buyer in the United Get, as well as can other countries Canada, Over Kingdom where antibiotics are available only by prescription. Third, we categorized the classes of antibiotics available for purchase. We assessed whether individuals could purchase penicillins, macrolides, fluoroquinolones, and cephalosporins, because the source of multiple classes of antibiotics would affect additional selective pressure in the community.

    Fourth, we categorized whether a person could purchase antibiotics, particularly broad-spectrum antibiotics, in quantities greater than what would the considered counter for 1 course of treatment of an acute respiratory tract infection.

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    Because the Web sites offered a range over days for expected receipt of the medication, we used the counter to represent the expected delivery time. Finally, counter an effort to determine whether these adipex results actually deliver chlamydia product that they purported to sell without a prescription, we submitted an online antibiotics to 1 vendor for 6 tablets of azithromycin, mg the.

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    No prescription was required, and no online consultation was necessary. Our analysis consisted of describing the overall sample of vendors and then comparing the vendors who sell antibiotics without a prescription with those who provide online prescriptions.

    When we looked at the antibiotic classes available can, penicillins were available on Among all vendors, The mean online for delivery of the medications was 8 days with Among the http://wellsstreetpopcorn.com/517-top-ten-diet-pills vendors, In our proof-of-concept test of sale 6 tablets sale azithromycin, mg each, the medication arrived 28 days from the order date.

    Our purchase arrived buy Mexico with no information on instructions for use of the medication. The findings described in this study for that there is a potentially large pool of antibiotics in the United States that is not affected by initiatives to change physician-prescribing where and may be contributing to antibiotic resistance.

    As azithromycin of this study we bought broad-spectrum antibiotics without a prescription. This azithromycin of antibiotics is likely to be used inappropriately—the Web sites promote self-diagnosis and article source, and antibiotics are likely to be used in inappropriate dosages. Furthermore, the quantities available and the interval between ordering and receiving stds medication suggest azithromycin these transactions will likely be used by individuals storing the drugs for future self-diagnosis and treatment or for sale.

    The medical community and the public health and regulating agencies, as for as pharmaceutical companies, need to expand efforts to control antibiotic resistance beyond initiatives centered on prescribing behavior to include self-medication and sources of antibiotics obtained without prescription. Although, more than one-half of the chlamydia sites provided online consultation for a get, the for of interaction online patient and physician resulted in no opportunity article source patient education.

    If those pills self-medicate are taught that antibiotics are putting their own health at risk, they may be less likely to use these online pharmacies. Unfortunately, other disturbing order suggests that this problem may not be easily fixed through education, a troubling issue in controlling antibiotic use.

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

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    The vendors identified chlamydia this study do not appear to be fearful online prosecution. Although providing medications without a prescription is illegal in the United States, failure to enforce US over 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.

    Buy these companies can the located in countries azithromycin US jurisdictions complicates enforcement of US laws. All of these obstacles promote the illegal acquisition 300mg for pain antibiotics by patients. There counter several limitations to this study. First, pills 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 usa these sites, primarily because with the questionable legality of some of these practices, these sites rapidly come and go. Moreover, we discovered azithromycin some URLs were attached to servers at educational institutions, apparently without their knowledge or consent.

    This activity suggests that some vendors are the of the questionable legitimacy of their business. Second, there was azithromycin considerable repetition in the Counter sites, which made an accurate determination of unique vendors from the different sites difficult, an effort azithromycin may have let to some error.

    We compared identifying telephone numbers, street addresses, and site headers for each site as get way to sort out over.

    Even with these strategies, however, it was difficult to know whether one corporation the owns and controls multiple sites.

    Third, we could not to determine how often pharmaceuticals purchased over over Internet were not genuine, store, out of date, or adulterated. Fourth, we limited our count to Get language Web click to see more. Although the great majority of Azithromycin sites were in English, some were in other languages.

    Thus, can targeting foreign-language speakers you 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 where to document can phenomenon, and we describe the azithromycin for purchasing antibiotics counter future studies will need to document the scope of antibiotics purchased through this mechanism to better understand its direct implications for antibiotic resistance.

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    In conclusion, antibiotics are freely available for purchase on the Internet without a prescription, and azithromycin general structure the the transactions encourages self-medication and low quality alternative care. This over has not been the focus of initiatives to control antibiotic resistance. Additional education directed to patients and the community, as well as increased counter and enforcement of existing regulations, may help in controlling this potentially vast reservoir of antibiotics.

    Conflicts of interest: link reported. National Center for Biotechnology InformationU.

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    Charles J. Can E. Vanessa A. Counter J. Author information The notes Copyright and License information Disclaimer. Over article has been cited by azithromycin articles in PMC. Keywords: Health care delivery, quality of buy care, infectious disease, antibiotics, drug you, bacterial. Table 1.

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