Untreated chlamydia. (mutational probability?)

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patient Z- Allows symptoms of Urethra pain and discomfort when urinating to go undiagnosed for over a year and is then tested for chlamydia which is positive. clinic treats patient with standard doxycycline antibiotics. Patient takes azithromycin for an alternative solution as the course of doxycycline seems ineffective, Symptoms persist and now abdominal discomfort is observed. what are the probable causes of both the antibiotics ineffectiveness and what are the clinical steps that should be taken in this case, Patient information: healthy on stats. 27 y/o ,normal BP, normal BMI, no pre existing health conditions, no drug medication administered prior to this instance.

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