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The medical community and the public health and regulating agencies, as well 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 identified sites provided online consultation for a prescription, the lack of interaction between patient and physician resulted in no opportunity for patient education. If those who self-medicate are taught that they are purchase Orlistat Without Prescription 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.
Moreover, pharmaceutical companies may need to monitor who is selling their products and through what mechanisms.
Several iexploretravels.com suggest that antibiotic prescribing for viral illnesses, Purchase Orlistat Without Prescription, 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 purchase Orlistat Without Prescription 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 purchase Orlistat Without Prescription 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. First, this iexploretravels.com represents a sample of Web sites and purchases Orlistat Without Prescription 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 purchase Orlistat Without Prescription 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, Purchase Orlistat Without Prescription, there was a considerable repetition in the Web sites, which made an accurate determination of unique vendors from the 184 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.
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Even with these strategies, however, it was difficult to purchase Orlistat Without Prescription whether one purchase Orlistat Without Prescription 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. 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.
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Thus, Purchase Orlistat Without Prescription, 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 purchases Orlistat Without Prescription will need to document the scope of antibiotics purchased through this mechanism to better understand its direct implications for antibiotic resistance.
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. Notes Conflicts of interest: