Patient description: Fernandez is a 41 year man who is a professional soccer player. He came to the clinic with itchy foot. Physical exam revealed localized scaling and maceration between the third and fourth of his right toe. It became inflamed and sore, with mild fissuring. The dorsum and sole of the foot was unaffected. There is no pus or tearing in the affected area. He didn't use ant topical ointment on the lesion and has no positive history for any underlying disease such as DM. He smokes 15 cigarettes per day and drinks a beer per day. His family history is positive for hyperlipidemia in her mother and MI in her father. He is in relation with several partners and use condom during the intercourse. His physical exam and lab studies were normal otherwise. Tinea pedis infection confirmed as his diagnosis by the observation of segmented fungal hyphae during a microscopic KOH wet mount examination.

Clinical trial eligibility criteria: eligible ages (years): 18.0-85.0,  Foot Ulcer, Diabetic Infection Has diabetes mellitus, according to the American Diabetes Association (ADA) criteria Has at least 1 skin ulcer located on or below the malleolus that presents with the following clinical manifestations of a moderate or severe infection based on the Infectious Disease Society of America guidelines for the "Diagnosis and Treatment of Diabetic Foot Infections" (CID 2012; 54:132-173) (IDSA guidelines) has ≥ 2 manifestations of inflammation (local swelling or induration, erythema, local tenderness or pain, local warmth, purulent discharge (thick, opaque to white or sanguineous secretion) has ≥ 1 of the following characteristics: erythema > 2cm, or involving structures deeper than skin and subcutaneous tissues (e.g. abscess, osteomyelitis, septic arthritis, fasciitis) For patients with multiple infected ulcers, the ulcer with the highest Diabetic Foot Infection Wound score (DFI score) must be on or below the malleolus and all infected ulcers must be completely coverable using no more than 4 sponges (sponges cannot be cut) Has documented adequate arterial perfusion in the affected limb(s) (either palpable dorsalis pedis and posterior tibial pulses, or normal Doppler wave forms, a toe blood pressure ≥ 45 mm Hg or participation is approved by a vascular surgeon) Has received appropriate surgical intervention to remove all necrotic and infected bone if diagnosed with osteomyelitis Has received appropriate surgical debridement to remove all gangrenous tissue  Has a known history of hypersensitivity to gentamicin (or other aminoglycosides) Has a known or suspected hypersensitivity to bovine collagen Has an ulcer infection which, based upon the patient's known history of hypersensitivity and/or as otherwise in the opinion of the investigator, cannot be adequately treated with at least one of the empiric systemic antibiotic regimens allowed by this protocol Has an ulcer associated with prosthetic material or an implanted device Has received any systemic or topical antibiotic therapy for any reason within 7 days of randomization unless it was administered to specifically treat the infected ulcer(s) and only within 36 hours of randomization Requires or is likely to require treatment with any concomitant topical product or wound therapy before the first follow-up study visit Is severely immunocompromised, or likely to become severely immunocompromised during the study, in the opinion of the investigator Has a history of myasthenia gravis or other neurological condition where gentamicin use is contraindicated as determined by the investigator Has a history of epilepsy Has a history of alcohol or substance abuse in the past 12 months