Because AST is rare and may present with varying levels of severity, there are few high-level evidence studies that clearly define optimal management strategies. AST was traditionally managed with a combination of surgical and medical treatment modalities involving partial or total thyroidectomy or surgical drainage and targeted antibiotic therapy. In more recent nonrandomized clinical practice and case reports, there has been a greater emphasis on an upfront medical approach with targeted IV antibiotic therapy [8, 16]. The optimal duration of IV antibiotic therapy is unclear, with expert opinion recommending 14 days . Isolated case reports have continued IV antibiotics for up to 37 days, even in patients who demonstrated early response . As our patient lacked signs of airway compromise and a drainable thyroid abscess, and improved rapidly over the first four days, the decision was made by day 8 to transition her to oral antibiotics and discharge on a 14-day total course. Further studies are needed to refine therapeutic approaches based on the severity of disease presentation.