Not something I've looked into in any detail, but I buy Kyodophilus brand probiotic mix that does'nt need refrigeration. Its what we gave our son along with the metronidazole (Flagyl) eight years ago, and he continued taking it for an additional six months at that time. It's what we take to replenish bowel flora after any antibiotics, and it seems to me to get us where we need to be. I don't know how it stacks up against the refrigerated kind, but worth looking into, at least for the stability.