It is useful to approach treatment failures systematically, as outlined below. Nevertheless up to 30 to 40 percent of cases may recur, especially those in which Chlamydia trachomatis is not involved. Tetracycline is the retreatment drug of choice. Failure to treat the sex partner or failure to overlap partner's treatment by several days. New infection from a new partner.
Patient fails to take the medication.
Some patients respond better to doxycycline, probably due to better compliance. If two to three courses of tetracycline fail, try erythromycin. Some patients are infected with tetracycline-resistant ureaplasma. These patients have no symptomatic relief while on tetracycline , as opposed to the more common scenario of reduced symptomatology while on tetracycline, with symptoms recurring when tetracycline is stopped. Patients who get no relief while on tetracycline should be treated with erythromycin.