Table 2.

Synthecure set times that required modified mixing techniques.

Antibiotic(s)/antifungal	Dose	Powder (P)/	Avg mix	Avg set	Observations
	(mg)	liquid (L)	time (min:s)	time (min:s)
Control	n/a	n/a	0:30	4:10
Ciprofloxacin	1000	P	1:30	7:25	PMP. Add powder at 60 s. Mix for an additional 30 s.
Ciprofloxacin	500	P	1:30	14:30	PMP. Add powder at 60 s. Mix for an additional 30 s.
Cefepime	500	P	1:30	10:20	PMP. Add powder at 60 s. Mix an additional 30 s.
Cefepime	1000	P	1:50	9:10	PMP. Add powder at 60 s. Mix an additional 50 s.
Ceftriaxone	500	P	0:25	19:20	Add an additional 5 cc of saline at beginning of mix.
Daptomycin	500	P	3:00	12:30	PMP. Add powder at 120 s (paste will be almost set). Mix an additional 60 s.
Ertapenem	500	P	2:15	13:15	PMP. Add powder at 120 s (paste will be almost set). Mix an additional 15 s.
Nafcillin	500	P	1:25	12:20	PMP. Add powder at 60 s. Mix an additional 25 s.
Nafcillin	1000	P	1:25	16:30	PMP. Add powder at 60 s. Mix an additional 25 s.
Unasyn	1500	P	2:20	10:10	PMP. Add powder at 120 s (paste will be almost set). Mix an additional 20 s.
Vancomycin/Ciprofloxacin	1000/1000	P/P	1:25	6:30	PMP. Mix Vanc. and CaSO ${}_{\mathrm{4}}$ . Wait 60 s before adding Cipro. Mix an additional 25 s.
Vancomycin/Tobramycin	1000/1200	P/P	1:45	17:50	PMP. Mix Vanc. and CaSO ${}_{\mathrm{4}}$ . Wait 45 s before adding Tobra. Mix an additional 60 s.
Vancomycin/Zosyn	1000/2250	P/P	2:00	16:15	PMP. Mix Vanc. and CaSO ${}_{\mathrm{4}}$ . Wait 90 s before adding Zosyn. Mix an additional 30 s.
Voriconazole/Vancomycin/ Tobramycin	200/1000/240	P/P/L	0:50	22:00	Inject 6 cc of liquid Tobramycin into the vial of Voriconazole. Shake bottle vigorously for 60 s, until all Voriconazole has dissolved. Aspirate 6 cc of liquid from the vial, add to Synthecure  $+$  Vancomycin powder, and mix until a smooth paste is achieved.

PMP: post-mix protocol. Mix CaSO ${}_{\mathrm{4}}$ with liquid until a smooth paste is achieved. Wait the prescribed time, then add desired antibiotic powder. n/a: not applicable.