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There are several limitations to this study. 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 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. 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 Third, we could not to determine how often pharmaceuticals purchased over the Internet were not genuine, inactive, out of date, or adulterated. 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. Notes Conflicts of interest: The epidemic of antibiotic-resistant infections: Clin Infect Dis. Microbial Treats to Health: Emergence, Detection, and Response. Washington, DC: Institute of Medicine; 2003. Infectious Diseases Society of America.

Bad Bugs, No Drugs: Alexandria, VA: Infectious Diseases Society of America; 2004. Sarkar P, Gould IM. Antimicrobial agents are societal drugs: Neu HC. The crisis in antibiotic resistance. Cohen ML. Epidemiology of drug resistance: Principles of appropriate antibiotic use for treatment of acute bronchitis in adults. Ann Intern Med. Information leaflet and antibiotic prescribing strategies for acute lower respiratory tract infection: An evaluation of statewide strategies to reduce antibiotic overuse. Fam Med. Decreasing antibiotic use in ambulatory practice: Availability of injectable antibiotics in a town market in southwest Cameroon.

Lancet Infect Dis. Antimicrobial resistance in Streptococcus pneumoniae, Taiwan. Emerg Infect Dis. The use of antimicrobial drugs in Nagpur, India. A window on medical care in a developing country. Soc Sci Med. Zithromax antibiotic is a prescription drug that comes in 250 mg, 500 mg tablets. It is available on prescription only as tablets for oral use, but the online pharmacy, will sell Zithromax without prescription. You may be able to order Azithromycin from them online and save the local pharmacy markup. Special information Take suspension formulation of this drug at least one hour before or two hours after meals.

If you buying Zithromax, you should also know, that tablets may be taken without regard to meals. Do not take aluminum or magnesium containing antacids at the same time with this drug. Do not cut, chew, or crush the tablets. Shake the suspension well before each use. Zithromax for diarrhea treatment You can buy azithromycin for treatment of diarrhea. Campylobacter is a group of bacteria that causes disease in humans and animals. It is one of the most common bacterial causes of diarrhea illness in the United States, and is very common throughout the world.

People diagnosed with campylobacter are often given prescriptions for the antibiotic ciprofloxacin , but the bacteria has become resistant to it in some areas. According to Canadian Family Physician , Zithromax tablets are effective in treatment of ciprofloxacin-resistant Campylobacter. Researchers found that azithromycin was superior to ciprofloxacin in decreasing the excretion of Campylobacter and as effective as cipro in shortening the duration of illness. What is Zithromax?


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Discontinue use if liver dysfunction occurs. Use caution if you have developed a certain type of abnormal heart rhythm called QT prolongation prior to therapy. Before you buy Zithromax you should know that safety and efficacy of this drug has not been established in children less than six months of age with acute bacterial infections of the ear, sinus or community-acquired pneumonia, or in children less than two years with tonsillitis. Drug interactions Pimozide, tacrolimus, phenytoin, ergot alkaloids, alfentanil, bromocriptine, tegretol, cyclosporine, digoxin, disopyramide, triazolam, nelfinavir, antacids containing aluminum or magnesium.

Consult your pharmacist or physician before starting any new therapy. Azithromycin is excreted in the breast milk and may accumulate. Each pharmaceutical form has its own advantages and disadvantages. Thus, pills, capsules and syrups are soft and painless in application, but if there are any problems with gastrointestinal system and there is a vasospasm of internal organs that is observed in case of high temperature , then preparation absorbability into blood decreases and concentrations of preparation necessary for fighting pathogenic microorganisms cannot be achieved. Despite the fact that intravenous and intramuscular injections of antibiotic are painful and their injection needs help of medical personnel, they allow inject strictly necessary amount of preparation.

Drops, suppositories and salves can have only local effect, but do not have adverse effects for the organism as a whole. Administration way is chosen depending on that where preparation should be transported, how quickly and in what amount. Therefore, in case of severe disease progression intravenous or intramuscular way is often chosen, in case of easy and medium disease progression - pills are chosen, for children - syrups are chosen, in case of eye infections - drops and salves are chosen, in case of skin infections - salves, solutions for outward application are chosen.

Combinations of antibiotics are often used. If combination was chosen in a right way, then one antibiotic increases effect of the other. What antibiotic to choose? Following microorganisms action spectrum antibiotics are divided into: In order to definitely know what antibiotic bacteria are sensitive in each case, bacteriological examination should be done. But results have to be waited for long and there is usually no time. I appreciate the swift and professional delivery! My wife and I would like to offer you our sincere thanks. Very prompt delivery! It was worth spending a few extra dollars just for getting the drugs I need on time.

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