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Introduction: During surgical procedure, antibioprophylaxis is known to decrease bacterial proliferation and limit postoperative complications such as infections. In France, antibiotic prescription guidelines have been established for ear surgery, but applied with discrepancies. The purpose of the study was to evaluate the necessity of antibioprophylaxis in ear surgery., Material and Methods: Retrospective study of two consecutives series of ear surgery with two different antibioprophylaxis protocols. In the first series (n=100), antibioprophylaxis by amoxicillin and clavulanic acid was given only in cases of chronic otitis media with otorrhea and cholesteatoma (contaminated surgery). In the second series (n=107), no antibiotic was administered. The number of infected complications was evaluated by reviewing medical charts., Results: The percentage of infected complications was 5% versus 6.5% in the second series (with no antibioprophylaxis), for all types of ear surgery, 9.4% versus 4.2% after ear contaminated surgery. No statistical difference was observed between the two series., Conclusion: In ear surgery, postoperative infected complications do not more frequently occur without antibioprophylaxis, either in otorrhea or in cholesteatoma surgery.

A case of post-traumatic meningitis with otorrhea due to Staphylococcus aureus was successfully treated with a cefotaxim-fosfomycin (CTX-FOS) combination. Serial samples of CSF leaking from the ear showed that maximal concentrations of CTX and FOS, 3.24 mg/l and 19.10 mg/l respectively, occurred one hour after the infusion of both antibiotics was terminated. For desacetyl-cefotaxim (D-CTX), maximal concentration (1.24 mg/l) occurred two hours later. These findings suggest that lumber puncture to control maximal penetration of CTX and FOS into CSF should be done one hour after infusion of both antibiotics.