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Modified triple antibiotic paste (MTAP) is a combination antimicrobial formulation used as an intracanal medicament in endodontic therapy, specifically for treating secondary endodontic infections and in regenerative procedures. Developed and evaluated by researchers at Tanta University, this specific formulation is modified typically by replacing minocycline with another antibiotic (such as clindamycin or cefaclor) to prevent the tooth discoloration associated with traditional triple antibiotic paste (TAP). The paste typically contains metronidazole, ciprofloxacin, and a third antibiotic, which work synergistically to eradicate persistent intracanal pathogens, most notably *Enterococcus faecalis*. Metronidazole provides activity against anaerobic bacteria, ciprofloxacin offers broad-spectrum gram-negative coverage, and the third agent targets gram-positive organisms.
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