Acute otitis media (AOM) is a painful type of ear infection. It occurs when the area behind the eardrum called the middle ear becomes inflamed and infected. It is a very common condition, but its management remains difficult .Accurate recognition of the disease represents the first dilemma .None of the symptoms are specific. Even the red tympanic membrane can be caused by the child’s crying or the viral upper respiratory infection that usually accompanies the disease. So AOM is commonly over diagnosed. Since the first line antibiotic therapy is considered as safe and well tolerated, even when the diagnosis is uncertain. This review article is focused on current therapy of antibiotics for acute otitis media