It is available in Australia without prescription from selected pharmacies and medical dispensaries.  New Zealand Pharmacies can supply Mutaflor® to a patient on request from an authorized prescriber based on Section 29 of the Medicines Act 1981.
As of 2011, it is no longer available for distribution in the U.S., because of changes in the FDA's rulings, known as the NDI (New Dietary Ingredient) guidelines that affects supplements and probiotics. Distributors outside the U.S. do not ship to the U.S. because of the FDA ruling.
Mutaflor and ME/CFS
Ken Lassesen writes in Health Rising about using Mutafor as one of the treatments that led to his remission. A possible rationale as reported by Ken Lassesen in his CFS Remission blog entry is as follows: "For CFS patients, several presentations at CFS conferences have reported that E.Coli population is very low in CFS patients, < 50% of controls. E.Coli produces NADH that is a precursor to Niacin (if you have niacin flushes, you are likely low on E.Coli). Niacin is a natural vascular dilator (keeps blood vessel wide/open), so its absence can result in reduced blood flow and brain fog."