Short answer
Post-treatment persistence is a diagnostic question with a ranked answer list: reinfection first, uncovered organisms second, non-adherence third, true resistance last. Worked through in order by your clinician, not guessed at home.
The ranking matters because each answer demands a different fix.
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See Tests & Prices →The ranked workup, and your role in it
Partner treatment verification and honest sexual history since therapy (the reinfection screen. Bring complete timelines).
Adherence audit (missed doses, vomiting, interactions. Disclose plainly; clinicians adjust without judgment).
Laboratory testing for organisms the first round didn’t cover (trichomoniasis, M.
genitalium where indicated).
Cultures with susceptibility testing for persistent gonorrhea.
Non-STI evaluation where patterns suggest it (UTI, prostatitis, dermatitis, BV/yeast).
Your contribution is information quality: accurate histories and honest adherence reporting are what let the ranking work.
How follow-up testing is scheduled around these questions is covered in Understanding a Negative STI Test Result.
True failure pathways stay specialist territory
Verified adherence plus persistent organism detection routes to resistance testing, clinician-directed alternative regimens, and specialist referral. Documented meticulously for surveillance.
Patients never manage this tier themselves; the correct patient action is returning promptly with documentation, not improvising stronger drugs.
What not to do while waiting
Repeat identical prescriptions, borrow stronger antibiotics, add home remedies, or abandon follow-up.
Pressuring clinicians for stronger drugs without evaluation, splitting courses with partners, or consulting forums instead of returning all belong on the same list.
Each delays the correct next step while transmission and complications continue. And borrowed antibiotics actively breed the resistance that makes true failure harder to treat.
The correct sequence never changes: return, report honestly, test as directed, and let results, not urgency, choose the next step.
When to seek care
Back promptly for any persistence past the expected improvement window; urgently for worsening pain, fever, swelling, or urinary retention.