Medical College of Wisconsin
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Availability of antibiotics for purchase without a prescription on the internet. Ann Fam Med 2009;7(5):431-5



Pubmed ID


Pubmed Central ID




Scopus ID

2-s2.0-70349182373 (requires institutional sign-in at Scopus site)   56 Citations


PURPOSE: Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. Most initiatives, however, focus almost exclusively on controlling prescribing by health care clinicians and do not focus on patient self-medication. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenomenon on the Internet.

METHODS: We conducted an Internet search using 2 major search engines (Google and Yahoo) with the key words "purchase antibiotics without a prescription" and "online (English only)." Vendors were compared according to the classes of antibiotics available, quantity, shipping locations, and shipping time.

RESULTS: We found 138 unique vendors selling antibiotics without a prescription. Of those vendors, 36.2% sold antibiotics without a prescription, and 63.8% provided an online prescription. Penicillins were available on 94.2% of the sites, macrolides on 96.4%, fluoroquinolones on 61.6%, and cephalosporins on 56.5%. Nearly all, 98.6%, ship to the United States. The mean delivery time was 8 days, with 46.1% expecting delivery in more than 7 days. Among those selling macrolides (n = 133), 93.3% would sell azithromycin in quantities consistent with more than a single course of medication. Compared with vendors that require a medical interview, vendors who sell antibiotics without a prescription were more likely to sell quantities in excess of a single course, and the antibiotics were more likely to take more than 7 days to reach the customer.

CONCLUSIONS: Antibiotics are freely available for purchase on the Internet without a prescription, a phenomenon that encourages self-medication and low quality of care.

Author List

Mainous AG 3rd, Everett CJ, Post RE, Diaz VA, Hueston WJ


William J. Hueston MD Adjunct Professor in the Family Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anti-Bacterial Agents
Health Services Accessibility
Prescription Drugs
Self Medication